Cabergoline versus bromocriptine for symptomatic treatment of premenstrual mastalgia: a randomised, open-label study.
OBJECTIVE
To compare the effectiveness and side effects of cabergoline with bromocriptine for the symptomatic treatment of cyclic mastalgia as a part of the premenstrual syndrome.


METHODS
140 women with premenstrual mastalgia were enrolled in this randomised, open-label trial. Two groups were created (bromocriptine and cabergoline) and consisted of 61 and 67 patients respectively at the end of trial. Bromocriptine was administered 5 mg daily during second half of the menstrual cycle. Cabergoline was administered 0.5 mg weekly during the second half of the cycle. Relief of pain was evaluated using a visual analog scale (VAS). The mean percentage decrease in score for all patients in each group was calculated. A 50% or greater decrease at the end of the third month from the basal VAS score was accepted as a positive response to drug therapy. Data regarding side effects were collected systematically with review of a symptom diary.


RESULTS
The positive response rates to treatment were similar (bromocriptine 66.6% and cabergoline 68.4%). The pain reduction rates for each month were also similar. Moreover, the pain reduction rate was maximum in the second month of treatment for both groups. Vomiting (28%), nausea (39%) and headaches (23%) recorded in the bromocriptine group were significantly more frequent than vomiting (4.5%), nausea (20.9%) and headache (6%) recorded in the cabergoline group (p=0.023, p=0.001, p=0.006 respectively). A difference in the rate of dizziness was not statistically significant (26.4% vs. 14.9%). There was no correlation between the baseline breast pain score and prolactin level but post-treatment pain reduction was well correlated with prolactin level.


CONCLUSIONS
Cabergoline is as effective as bromocriptine for the treatment of cyclic mastalgia but has minimal side effects compared to bromocriptine.
Aydin
Yavuz
Y
Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. yavuzay@istanbul.edu.tr
Atis
Alev
A
Kaleli
Semih
S
Uludağ
Seyfettin
S
Goker
Nimet
N
D000328:Adult; D000704:Analysis of Variance; D001940:Breast / Q000503:physiopathology*; D001971:Bromocriptine / Q000627:therapeutic use*; D000077465:Cabergoline; D004334:Drug Administration Schedule; D004873:Ergolines / Q000627:therapeutic use*; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D011293:Premenstrual Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011388:Prolactin / Q000097:blood; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
D004873:Ergolines; D006727:Hormone Antagonists; D001971:Bromocriptine; D011388:Prolactin; D000077465:Cabergoline