ArticleEndocrine2017
Dopa-testotoxicosis: disruptive hypersexuality in hypogonadal men with prolactinomas treated with dopamine agonists.
Article in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Italian Guidelines for the Management of Prolactinomas.Endocrine, metabolic & immune disorders drug targets · 2023Guideline
- Surgery as a Viable Alternative First-Line Treatment for Prolactinoma Patients. A Systematic Review and Meta-Analysis.The Journal of clinical endocrinology and metabolism · 2020Pooled it
- Prolactinoma assessment and management: an international multidisciplinary cross-sectional survey of current practice.Pituitary · 2026Article
- Impulse control disorders and their relationship with psychopathology in patients treated with cabergoline for hyperprolactinaemia.Pituitary · 2026Article
- Article
- Increased Cardiometabolic Risk in Men with Hypoprolactinemia: A Pilot Study.Biomolecules · 2024Article
- Impulse Control Disorders in Southern Iraqi Patients Medicated With Cabergoline for Prolactinoma.Cureus · 2024Article
- Research status and prospects of pituitary adenomas in conjunction with neurological and psychiatric disorders and the tumor microenvironment.Frontiers in neuroscience · 2024Review
- Prolactin-secreting pituitary adenomas: male-specific differences in pathogenesis, clinical presentation and treatment.Frontiers in endocrinology · 2024Review
- Low prolactin level identifies hypoactive sexual desire disorder women with a reduced inhibition profile.Journal of endocrinological investigation · 2023Article
- Impulse control disorders in hyperprolactinemic patients on dopamine agonist therapy.Reviews in endocrine & metabolic disorders · 2022Review
- Treatment of Prolactinoma.Medicina (Kaunas, Lithuania) · 2022Review
- The side effects of dopamine receptor agonist drugs in Chinese prolactinoma patients: a cross sectional study.BMC endocrine disorders · 2022Article
- Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors.European journal of endocrinology · 2022Article
- Dopamine agonist therapy for prolactinomas: do we need to rethink the place of surgery in prolactinoma management?Endocrine oncology (Bristol, England) · 2022Review
- Article
- Increased prevalence of impulse control disorder symptoms in endocrine diseases treated with dopamine agonists: a cross-sectional study.Journal of endocrinological investigation · 2021Article
- Prolactinomas in males: any differences?Pituitary · 2020Review
- Article
- Impulse control disorders in patients with prolactinoma receiving dopamine agonist therapy: a prospective study with 1 year follow-up.Endocrine · 2018Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Dopamine agonists are the first line of therapy for prolactinomas, with high rates of biochemical control and tumour shrinkage. Toxicity is considered to be low and manageable by switching of agents and dose reduction. Dopamine agonist-induced impulse control disorders are well described in the neurology setting, but further data are required regarding this toxicity in prolactinoma patients. We performed a multicenter retrospective cohort study of eight men with prolactinomas and associated central hypogonadism. The eight men had no prior history of psychiatric disease, but each developed disruptive hypersexuality whilst on dopamine agonist therapy at various doses. Cabergoline, bromocriptine and quinagolide were all implicated. Hypersexuality had manifold consequences, including relationship discord, financial loss, reduced work performance, and illicit activity. We hypothesise that this phenomenon is due to synergy between reward pathway stimulation by dopamine agonists, together with rapid restoration of the eugonadal state after prolonged hypogonadism. We refer here to this distinct drug toxicity as 'dopa-testotoxicosis'. Given the profound impact in these patients and their families, cessation of dopamine agonists should be considered in men who develop hypersexuality, and pituitary surgery may be required to facilitate this. Awareness of this distinct impulse control disorder should enable further research into the prevalence, natural history and management of dopa-testotoxicosis. The condition is likely under-reported due to the highly personal nature of the symptoms and we suggest a simple written questionnaire to screen for hypersexuality and other behavioural symptoms within the first six months of dopamine agonist treatment.
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