Benserazide and nomifensine in the diagnosis of prolactin-secreting pituitary adenomas.
Benserazide, an inhibitor of dopa-decarboxylase, stimulates prolactin (Prl) release in normal women and in puerperae; nomifensine, a dopaminergic drug able to release dopamine and to inhibit its re-uptake at the post-synaptic level, inhibits Prl release in the same subjects. Similar modifications of Prl release are evident in selected cases of non-tumoral hyperprolactinaemia, while neither drug modifies Prl release in patients with a Prl-secreting pituitary adenoma, in patients with 'functional' hyperprolactinaemia and in patients with 'functional' hyperprolactinaemia and in patients with minor abnormalities of sellar tomography. Neither drug modified Prl release in patients with macro- or microadenomas; several patients in the remaining groups failed to respond to one or both tests, the concordance between the two tests averaging 75%. Patients responding to both tests, to one test or to neither test showed progressively higher basal Prl levels. Since benserazide and nomifensine can indicate the presence of a pituitary adenoma earlier than sellar tomography, our results indicate that patients with no Prl response to one or to both tests probably harbour a pituitary adenoma which cannot yet be revealed by sellar tomography.
D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism*; D001545:Benserazide / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006834:Hydrazines / Q000494:pharmacology*; D007546:Isoquinolines / Q000494:pharmacology*; D009627:Nomifensine / Q000494:pharmacology*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D049590:Postpartum Period; D011247:Pregnancy; D011388:Prolactin / Q000097:blood / Q000378:metabolism*
D006834:Hydrazines; D007546:Isoquinolines; D009627:Nomifensine; D001545:Benserazide; D011388:Prolactin