Dopamine treatment constitutes a major advance towards the management of severe
ovarian hyperstimulation syndrome (OHSS) by causing renal and mesenteric vasodilatation as well as
diuretic and positive inotropic actions.
Docarpamine, an oral
dopamine prodrug, is converted into
dopamine after enteral administration, and the generated
dopamine causes renal vasodilatation and diuresis. The purpose of this study was to assess whether
docarpamine had beneficial effects in patients with OHSS. Twenty-seven patients, hospitalized because of OHSS and refractory to the initial
therapy with intravenous
albumin, were treated by
docarpamine, after informed consent had been obtained. A 750-mg
tablet of
docarpamine was taken every 8 h. In some cases, the plasma levels of free
dopamine were measured. The daily urinary outputs before and 1, 2, 3 and 4 days after the
docarpamine treatment were 839 +/- 424 ml, 1121 +/- 608 ml, 1168 +/- 504 ml, 1325 +/- 815 ml and 1133 +/- 509 ml, respectively. There were significant differences between the first and each of the others (p < 0.05). In 19 (86.4%) of 22 patients treated, clinical symptoms associated with
ascites were gradually improved after administrating
docarpamine. The plasma free
dopamine concentration rose to as high as 55.9 +/- 33.2 mg/ml during the first hour, which corresponded to the usual
intravenous drip infusion treatment with
dopamine. Moreover, there were no major adverse effects of
docarpamine in this study. This was the first demonstration of
docarpamine treatment in patients with intravenous
albumin-resistant OHSS. Although no effect was seen in pregnant women, diuresis was increased in some women, and
ascites decreased. These findings indicate that oral
docarpamine administration could be one of the options in the management of patients with OHSS using
dopamine therapy.