Hyperprolactinemia pergolide

In the hypothalamus, DA released into the pituitary decreases prolactin release. DA agonists (e.g., pergolide) are used to treat hyperprolactinemia antagonists may cause endocrine dysfunction. 

DA agonists (particularly D-2) are also of therapeutic and theoretical interest. They could add therapeutically to the few available drugs to treat Parkinson s disease, acromegaly, and hyperprolactinemia (e.g., bromocriptine, pergolide, Chapter 9, Fig. 9-2). Such compounds theoretically may aid in the characterizations of DA-receptor geometry and topography that have not yet been satisfactorily established. 

Pergolide ( PERMAX), an ergot derivative approved by the FDA for treatment of Parkinson s disease, also is used off label to treat hyperprolactinemia. It induces many of the same side effects as does bromocriptine, but it can be given once a day, starting at 0.025 mg at bedtime and increased gradually to a maximum daily dose of 0.5 mg. 

Hyperprolactinemia and parkinsonism Bromocriptine and pergolide are used to reduce prolactin secretion (dopamine is the physiologic prolactin release inhibitor). Bromocriptine also appears to reduce the size of pituitaiy tumors of the prolactin-secreting cells. This drug is also useful in the treatment of Parkinson s disease (Chapter 27). 

F. Prolactin-Inhibiting Hormone (PIH, Dopamine) Dopamine is the physiologic inhibitor of prolactin release. Because of its peripheral effects and the need for parenteral administration, dopamine is not useful in the control of hyperprolactinemia, but bromocriptine and other orally active ergot derivatives (eg, cabergoline. pergolide) are effective in reducing prolactin secretion from the normal gland as well as from pituitary tumors. 

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