management
Last reviewed 01/2018
- withdrawal of the drug suspected of causing raised prolactin - this is only way to sure that hyperprolactinaemia is drug-induced - the prolactin level should be remeasured 4-6 weeks later; if there is no symptomatic improvement or prolactin levels remain high then non-drug causes of hyperprolactinaemia should be considered
- if medication cannot be withdrawn (for example in the treatment of major psychosis) then substitution with an alternative drug (e.g. atypical neuroleptic) should be considered; if this is not a possible (or successful) management option then it may be possible to treat concomittantly with a dopamine agonist - however note that in some cases a dopamine agonist may antagonise the therapeutic effects of a drug where dopamine antagonism is essential to the efficacy of the drug (e.g. antiemetics)