Drug-induced hyperprolactinemia is treated with which therapy?

Drug-induced hyperprolactinemia is treated with which therapy?

• A. Dopamine agonists (bromocriptine, cabergoline)
• B. Dopamine antagonists
• C. Estrogen therapy
• D. Antidepressants

Answer: (A)

Prolactin release from the pituitary is kept in check by dopamine signaling through D2 receptors on lactotrophs. When this dopaminergic inhibition is reduced or blocked—such as by certain drugs that antagonize dopamine receptors—prolactin levels rise, leading to symptoms like galactorrhea and menstrual disturbances. Treating drug-induced hyperprolactinemia focuses on restoring dopaminergic inhibition of prolactin. Dopamine agonists such as bromocriptine or cabergoline bind to D2 receptors on lactotrophs and suppress prolactin secretion, typically lowering prolactin levels and alleviating symptoms. Bromocriptine and cabergoline are commonly used because they effectively reduce prolactin and have favorable tolerability profiles, with cabergoline often preferred for its longer action and fewer side effects. In practice, the first step with drug-induced hyperprolactinemia is usually to address the offending medication (switch to a prolactin-sparing agent or adjust the dose). If symptoms persist or adjustment isn’t possible, a dopamine agonist can be employed to control prolactin.

Prolactin release from the pituitary is kept in check by dopamine signaling through D2 receptors on lactotrophs. When this dopaminergic inhibition is reduced or blocked—such as by certain drugs that antagonize dopamine receptors—prolactin levels rise, leading to symptoms like galactorrhea and menstrual disturbances.

Treating drug-induced hyperprolactinemia focuses on restoring dopaminergic inhibition of prolactin. Dopamine agonists such as bromocriptine or cabergoline bind to D2 receptors on lactotrophs and suppress prolactin secretion, typically lowering prolactin levels and alleviating symptoms. Bromocriptine and cabergoline are commonly used because they effectively reduce prolactin and have favorable tolerability profiles, with cabergoline often preferred for its longer action and fewer side effects.

In practice, the first step with drug-induced hyperprolactinemia is usually to address the offending medication (switch to a prolactin-sparing agent or adjust the dose). If symptoms persist or adjustment isn’t possible, a dopamine agonist can be employed to control prolactin.