Prolactinomas

To the Editor: In the study protocol described by Colao et al. (Nov. 20 issue),¹ cabergoline was given at a dose of 0.5 mg per week to patients with nontumoral hyperprolactinemia, microprolactinomas, or macroprolactinomas and then stopped abruptly. I propose that cabergoline be tapered off rather than abruptly stopped, to avoid potential rebound hyperprolactinemia. The dose can be reduced from the typical dose of 0.25 mg twice a week, to 0.25 mg once a week, and then to 0.25 mg every other week before discontinuation. Serum prolactin levels can be measured one month after dose reduction and the reduction continued . . .