The Combination Therapy with Bromocriptine and Cyproheptadine in Patients with Acromegaly

• Published in: Endocrinologia Japonica Vol. 36; no. 3; pp. 429 - 438
• Main Authors: HANEW, KUNIHIKO, SUGAWARA, AKIRA, SHIMIZU, YASUYUKI, SATO, SHUICHI, SASAKI, ATSUSHI, TAZAWA, SATORU, ISHII, KIYOSHI, SAITOH, TSUYOSHI, SASO, SHUNICHI, YOSHINAGA, KAORU
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 1989
• Subjects: Acromegaly - blood; Acromegaly - complications; Acromegaly - drug therapy; Adenoma - complications; Adenoma - diagnostic imaging; Adenoma - drug therapy; Adult; Aged; Bromocriptine - administration & dosage; Bromocriptine - therapeutic use; Cyproheptadine - administration & dosage; Cyproheptadine - therapeutic use; Drug Therapy, Combination; Female; Growth Hormone - blood; Growth Hormone-Releasing Hormone - physiology; Humans; Male; Middle Aged; Pituitary Neoplasms - complications; Pituitary Neoplasms - diagnostic imaging; Pituitary Neoplasms - drug therapy; Prolactin - blood; Thyrotropin-Releasing Hormone - physiology; Time Factors; Tomography, X-Ray Computed
• ISSN: 0013-7219; 2185-6370
• DOI: 10.1507/endocrj1954.36.429

The therapeutic efficacy of the combination of cyproheptadine and bromocriptine was studied in 15 patients with active acromegaly showing incomplete GH suppression in response to bromocriptine therapy alone. The mean basal plasma GH was 31.3±5.5μg/L, and it decreased to 19.0±3.9μg/L during the single bromocriptine therapy (10 to 20mg for 2 to 21 months). When cyproheptadine (12 to 16mg for 8 to 52 months) was added to bromocriptine therapy, plasma GH decreased further (9.4±3.0μg/L: vs pretreatment, P<0.001; vs bromcriptine treatment, P<0.005), and GH normalization was obtained in 8 patients. The plasma somatomedin-C levels in these 8 patients (0.3-1.8U/ml) were within the normal range during the combination therapy. Plasma GH responses to TRH or GHRH were markedly suppressed in 6 patients during the combination therapy compared to pretreatment or during bromocriptine treatment. In addition, a clear reduction in the tumor size was observed in 4 of 7 previously untreated patients during the combination therapy. In conclusion, cyproheptadine has therapeutic efficacy in acromegalic patients who showed incomplete GH suppression in response to treatment with bromocriptine alone. Following the cyproheptadine and bromocriptine combination therapy tumor shrinkage was observed in some patients.