ergoline and Intracranial-Hemorrhages

We assessed several classes of serotonergic drugs in order to evaluate whether they constitute a risk factor for hospitalization for bleeding (gastrointestinal, intracranial, or in the female genital tract). A case-control study was conducted using data from the PHARMO record linkage system (RLS). The study population comprised 28,289 cases and 50,786 matched controls. Current use of antidepressant drugs was associated with all three types of bleeding, whereas antipsychotic drugs were associated with an increased risk of gastrointestinal and intracranial bleeding. Current use of ergoline derivatives increased the risk of female genital tract bleeding. The risks of gastrointestinal and intracranial bleeding were higher in new users of antidepressant and antipsychotic drugs as compared with those who were already receiving these drugs. No clear association was found between the degree of affinity for the serotonin (5-HT) transporter or the 5-HT(2A) receptor and the risk of any of the three types of bleeding. The association between antipsychotic drugs and gastrointestinal bleeding may warrant further research, in view of the fact that this association was rather unexpected.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antidepressive Agents; Antipsychotic Agents; Case-Control Studies; Ergolines; Female; Gastrointestinal Hemorrhage; Genital Diseases, Female; Hemorrhage; Hospitalization; Humans; Intracranial Hemorrhages; Male; Medical Record Linkage; Middle Aged; Receptor, Serotonin, 5-HT2A; Risk Factors; Serotonin 5-HT2 Receptor Agonists; Serotonin Agents; Serotonin Plasma Membrane Transport Proteins; Young Adult

Treatment of prolactin-secreting pituitary adenomas by dopamine agonists is highly effective and currently is used as basic treatment in most cases, however, literature sources practically do not contain data about possible complications of this therapy. We described a total of 11 cases of deterioration due to primary treatment of macroprolactinomas by cabergoline in the series of 176 patients. The first group included patients with enlargement of the tumor producing deterioration of the symptoms (onset of visual disorders and/or cephalgia). This occurred in 3 (1.7%) cases due to intratumoral hemorrhage or cystic transformation, and in 1 (0.6%) case as a result of growth of cabergoline-resistant tumor. The second group was made up of 6 (3.4%) cases of nasal CSF leak which developed within 3 to 6 weeks after start of treatment. All patients with CSF leak had adenomas with high sensitivity to the drug which produced rapid and significant shrinking of the tumor. The third group was presented by the single case (0.6%) of visual deterioration due to development of empty sella syndrome with dislocation of chiasm and optic nerves into sellar cavity.

Topics: Adolescent; Adult; Cabergoline; Cerebrospinal Fluid Rhinorrhea; Dopamine Agonists; Ergolines; Humans; Intracranial Hemorrhages; Male; Middle Aged; Neurosurgical Procedures; Pituitary Neoplasms; Prolactinoma; Radiography; Treatment Outcome; Vision Disorders; Young Adult