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Dopaminergic Challenge With Bromocriptine in Patients With Severe Brain Injury
Intensive Care Medicine Experimental volume 3, Article number: A485 (2015)
Bromocriptine Mesylate (BC) is an ergot derivative with potent dopamine receptor agonist activity. It is licensed to reduce plasma levels of prolactin. BC has central nervous effects, and is used in patients with Parkinson's disease. There are few randomized controlled trials with BC conducted in moderate brain injury (BI) with conflicting results (1). We aim to present our single center experience on dopaminergic challenge using off-label BC in patients with severe BI.
Glasgow Coma Score (GCS) are 3-10 (GCS: worst score = 3, best score = 15) at beginning of BC administration. Patients received 2.5mg of BC q6h after hemodynamic stability was ensured and no further neurologic improvement was observed during course of management. BC was started and discontinued on the discretion of the ICU team. Long term cognitive tests are under assessment.
A total of 18 patients were treated with BC. the average age was 48.9 (82-18) (12M/6F).
Our results show some neurologic improvement as assessed by GCS. More research is warranted before BC can be recommended in BI.
Frenette AJ, Kanji S, Rees L, Williamson DR, Perreault MM, Turgeon AF, et al: Efficacy and safety of dopamine agonists in traumatic brain injury: a systematic review of randomized controlled trials. J Neurotrauma. 2012, 29 (1): 1-18. 10.1089/neu.2011.1812.
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Celik, J., Duman, A., Arun, O. et al. Dopaminergic Challenge With Bromocriptine in Patients With Severe Brain Injury. ICMx 3, A485 (2015) doi:10.1186/2197-425X-3-S1-A485
- Brain Injury
- Glasgow Coma Score
- Single Center Experience