Inhibition of prolactin secretion by low-dose dopamine infusion in patients with hyperprolactinaemia

Dopamine inhibits the secretion of prolactin from the pituitary. We have examined the relation between plasma dopamine and serum prolactin in 12 patients with hyperprolactinaemia during the infusion of dopamine at low doses (0.01, 0.1 and 1 microgram/kg/min). Plasma dopamine levels were raised from less than 100 pg/ml at the lowest rate of infusion to more than 20 000 pg/ml at the highest. Suppression of prolactin secretion was seen in some patients even at the lowest rate of infusion (0.01 microgram/kg/min); marked suppression of prolactin secretion (60%; 17--83%) was found at the intermediate dose (0.1 microgram/kg/min) in 11 of the 12 subjects with little further decrease in serum prolactin (70%; 50--87%) in those in whom the rate of dopamine infusion was increased ten-fold. One patient with the highest serum prolactin (82 500 mu/l) showed no decrease in prolactin either at the lowest or intermediate rates of dopamine infusion. Serum prolactin levels returned to values similar to or greater than basal on cessation of dopamine infusion. Infusion of dopamine at doses much lower than previously used in man exposes the pituitary to a concentration of dopamine sufficient to suppress prolactin secretion. These observations have important implications in understanding the pathophysiology of prolactin secretion from the pituitary gland and for future investigations of the control of hormone release by dopamine.