Efficacy and long-term outcomes of dopamine agonist treatment in prolactinomas

Prolactinoma is the most common type of functional pituitary tumor. Prolactinomas have the potential to cause significant morbidity in both women and men. Since their discovery in the 1970s as an effective and safe treatment for patients with prolactinoma, dopamine agonists have become the cornerstone of prolactinoma pharmacotherapy. In this review, we discuss the various aspects of response to dopamine agonist therapy in different patient populations affected by prolactinoma, and in various settings. We review the evidence regarding response to dopamine agonist treatment, its side effects, and rates of normoprolactinemia following treatment withdrawal. These topics are essential, especially in light of recent literature challenging the paradigm of dopamine agonists as first-line therapy for all prolactinomas, and the trend toward upfront surgery as a viable treatment option for certain cases of prolactinoma.