What medicine should I take for hyperprolactinemia?

What medicine is good for hyperprolactinemia? Hyperprolactinemia must be treated early to avoid harm. Experts point out that hyperprolactinemia has many harms, but everyone must choose the appropriate treatment method based on their actual situation to avoid the harm of the disease. Taking medicine alone is not enough, and other treatments are also needed.

1. Anti-prolactin drugs

Antiprolactin includes bromocriptine, long-acting bromocriptine, tergoline, cabergoline, terguride, methylergoline, quinagoline, and lisuride.

2. Surgery

It is suitable for patients with giant adenomas that present intracranial compression symptoms, who are ineffective with bromocriptine treatment, giant adenomas, and serotonin-induced cell tumors that secrete multiple pituitary hormones. The current transsphenoidal microsurgery is safe, convenient, and easy to perform, and its efficacy is similar to that of bromocriptine therapy. The combination of bromocriptine before and after surgery can improve the efficacy. The disadvantages of surgery are that pituitary tumors have no obvious capsule and unclear boundaries, and it is not easy to be thorough or damaged during surgery, which can cause cerebrospinal fluid nasal fistula and postoperative hypopituitarism. It is worth noting that although preoperative bromocriptine treatment can shrink the tumor, it can cause tumor fibrosis, sclerosis, and adhesion of surrounding tissues, which is not conducive to surgical separation and resection. Therefore, if surgery is determined, medication can be temporarily stopped before surgery, and medication or radiotherapy can be supplemented after surgery.

The mortality rate of microsurgical resection of pituitary prolactin adenoma is less than 0.5%, the incidence of temporary diabetes after surgery is 10-40%, and permanent diabetes and iatrogenic hypothyroidism are less than 2%. The probability of prolactin and ovulation returning to normal after surgery for microadenomas is 65-85%, and for macroadenomas it is 20-40%, and 85% of patients have normal visual fields.

3. Chemotherapy

It is suitable for non-functional tumors of the hypothalamus-pituitary system and those who have not responded to drug and surgical treatment. Currently, advanced stereo focused radiotherapy methods are mostly used, including: deep X-rays, γ, 60Co, α particles and proton rays, radionuclide 90Y, 198Au pituitary implantation, etc.