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Bromocriptine for weight loss: An interview with Dr. Albert H. Meier
Thursday, October 15, 2009 1:51 pm Email this article
Here is an interview that I did in 1997 with Dr. Albert H. Meier about using bromocriptine for weight loss.
He had done several studies on the drug. Larry Hobbs: Which form of bromocriptine is best for weight loss–quick-release (Ergoset) or slow-release (Parlodel SRO)?
Dr. Albert H. Meier: Quick-release. You want to give a pulse of the drug to suppress prolactin at the right time and then let it clear out of the system to get a rebound effect at another time of the day.
Larry Hobbs: So the timing of the dose is important?
Dr. Meier: Yes. We’ve shown in animals that giving it at one time of day makes then lose weight, but at another time of day makes them gain weight. There is also some anecdotal evidence that this may also be the case in humans.
Larry Hobbs: When should it be given?
Dr. Meier: 8 AM works well for most people who keep normal hours. You don’t want to give it before someone goes to bed. It is more complicated, however, for people who work a night shift. Ideally hormone levels would be measured in each person to determine the timing of the dose, but that is not very practical.
Larry Hobbs: What dose should be given?
Dr. Meier: We used 1.6 to 2.4 mg per day. Higher doses can be used, however, side effects tend to be dose-dependent.
Larry Hobbs: How does bromocriptine cause weight loss?
Dr. Meier: Bromocriptine shifts the timing of dopaminergic activity which resets a biological clock in the brain.
There are several possible ways it may cause weight loss.
Bromocriptine may reduce appetite because it is a dopamine D2 agonist and dopamine is involved in the regulation of food intake.
Bromocriptine also decreases lipogenesis (the conversion of carbohydrate-to-fat) and increases protein turnover which leads to improved body composition.
This is because bromocriptine decreases insulin secretion and increases insulin sensitivity.
During a 2-week trial of non-diabetic obese individuals we found that bromocriptine reduced excess insulin levels 30 to 70 percent while also reducing blood sugar levels. (Cincotta AH, Meier AH, et al, 1995.)
Larry Hobbs: Does bromocriptine need to be taken indefinitely?
Dr. Meier: Maybe in some people maybe, but not in other.
Larry Hobbs: In what percentage of patients does bromocriptine cause weight loss?
Dr. Meier: About two-thirds. You’ll know quickly, within several weeks, in which patients it is working and which it is not.
Larry Hobbs: What are the side effects?
Dr. Meier: About 10 percent of people report slight nausea. It helps to take it with juice or milk.
Larry Hobbs: Does bromocriptine change blood lipids and blood sugar?
Dr. Meier: Yes. It helps to lower triglycerides, cholesterol, blood sugar, and free fatty acids. These changes are important to alleviating the diabetic/obesity syndrome.
Larry Hobbs: How safe is bromocriptine?
Dr. Meier: It’s a fairly benign drug. It has been used for 20 years without many problems. There were some problems when it was used to suppress lactation in women following a pregnancy. But it is no longer recommended for that.
Larry Hobbs: What are you working on now?
Dr. Meier: The other piece of the puzzle.
There is the stimulus portion which bromocriptine addresses, but now we are working on addressing the responsiveness of the receptors that receive that stimulus.
We hope this will help the one-third of people that don’t respond to bromocriptine.
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