Elevated prolactin (differential)

Elevated prolactin can be due to a number of causes, including elevated production/secretion and reduced inhibition. 

Prolactin is controlled by numerous homeostatic mechanisms, with tonic secretion of prolactin inhibitory hormone (dopamine) by the hypothalamus having a dominant effect 1.

Mechanical interruption of the portal transport of dopamine from the hypothalamus to the anterior pituitary gland (known as stalk effect) will reduce inhibition and thus result in minor elevation of prolactin.

Similarly, dopamine antagonists (such as the antipsychotic haloperidol and chlorpromazine ) as well as a long list of other drugs (including selective serotonin reuptake inhibitors (SSRI), monoamine oxidase inhibitors (MAO-I) and some tricyclic antidepressants), can cause hyperprolactinemia 1.

The highest levels of circulating prolactin are, however, encountered in the setting of prolactin secretion pituitary macroadenomas, especially those that are large and invading the cavernous sinus. 


Share article

Article Information

rID: 51532
Section: Gamuts
Synonyms or Alternate Spellings:

Support Radiopaedia and see fewer ads

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.