Jill, the medical literature is very clear the front line treatment is Cabergoline (Dostinex), not Bromocriptine (Parlodel). It generally has fewer side effects, dosing is more convenient, and is somewhat more effective at controlling prolactin. However Dostinex is sometimes not covered by insurance. Insurance companies figure it's only 10-15% more effective, and it's no skin off their nose if you get sick on Bromocriptine. In actuality you can have side effects with any dopamine agonist, including Dostinex. However if you have problems with Bromocriptine, it only makes sense to switch to a drug that often (though not always) has fewer side effects. If drugs don't work then surgery may be needed. But give the drugs a chance first. They work in about 90% of cases. In very roughly 50% of cases the drugs will shrink the tumor in addition to controlling prolactin. You're right some surgery patients still require drugs, since the surgery may not remove 100% of the tumor. Surgery is safe and effective, if done by a Dr. with lots of experience. Ideally see a surgeon like Dr. Hrayr K. Shahinian in California, who has vast experience.with endoscopic pituitary surgery. See http://www.skullbaseinstitutecom/ for details. | 