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if medication cannot be withdrawn (for example in the treatment of major psychosis) then substitution with an alternative drug (e.g. atypical neuroleptic) should be considered; if this is not a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)
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