Bromocriptine Lowers Cortisol, Suppresses ACTH

LCohen

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Long term bromocriptine therapy in Cushing's disease. - PubMed - NCBI

"Subsequently, an inhibitory effect on ACTH secretion was reported using bromocriptine in Cushing's disease. While most studies have focused on the acute response to bromocriptine, few have investigated the response to chronic therapy with this agent."

ACTH and cortisol response to bromocriptine, and results of long-term therapy, in Cushing's disease. - PubMed - NCBI
"Plasma corticotrophin (ACTH) was lowered in 4 out of 5 patients with pituitary dependent Cushing's syndrome (one of whom was studied only after bilateral adrenalectomy) after a single oral dose of 2.5 mg bromocriptine, but plasma cortisols were unaltered in the 3 patients in whom it was measured"

Medscape: Medscape Access
"Bromocriptine is a potent dopamine receptor agonist. The exact mechanism of action on ACTH modulation is not known; however, some investigators have suggested dopaminergic modulation of ACTH via CRH release, as well as direct suppression of ACTH. Approximately 40% of patients had normalized urine or plasma cortisol levels after chronic bromocriptine treatment.[45] Unfortunately, the ACTH response to a single dose of bromocriptine does not predict which patients respond to long-term therapy, and thus, higher doses may be needed to achieve a response.[44]Bromocriptine reduced plasma ACTH levels in 12 patients postadrenalectomy with elevated ACTH levels in the absence of a pituitary macroadenoma. Yet there was no significant change when bromocriptine was combined with cyproheptadine."

It works by inhibiting the release of CRH at the hypothalamus, they also point that it should be used long-term.
 
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