It should be understood, however, that the greater affinity bromocriptine and many similar antiparkinsons drugs have for the D2S receptor form (considered to be mostly present at inhibitory D2 autoreceptor locatations) relative to the D2L form, sufficiently low partial agonist activity (ie where a molecule binding to a receptor induces limited effects while preventing a stronger ligand like dopamine from binding), and, possibly, the functional selectivity of a particular drug may generate antidopaminergic effects that are more similar than oppositional in nature to antipsychotics. Pulmonary fibrosis has been reported when bromocriptine was used in high doses for the treatment of Parkinsons disease.Use to suppress milk production after childbirth was reviewed in 2014 and it was concluded that in this context a causal association with serious cardiovascular, neurological or psychiatric events could not be excluded with an overall incidence estimated to range between 0.005% and 0.04%. Additional safety precautions and stricter prescribing rules were suggested based on the data. It is a bile salt export pump inhibitor.After long-term use of dopamine agonists, a withdrawal syndrome may occur during dose reduction or discontinuation with the following possible side effects:  anxiety, panic attacks, dysphoria, depression, agitation, irritability, suicidal ideation, fatigue, orthostatic hypotension, nausea, vomiting, diaphoresis, generalized pain, and drug cravings. For some individuals, these withdrawal symptoms are short-lived and they make a full recovery, for others a protracted withdrawal syndrome may occur with withdrawal symptoms persisting for months or years. Pharmacology
Pharmacodynamics
Bromocriptine is a partial agonist of the dopamine D2 receptor.
Roths spots, also known as Litten spots or the Litten sign, are non-specific red spots with white or pale centres, seen on the retina and although traditionally associated with infective endocarditis, can occur in a number of other conditions including hypertension, diabetes, collagen vascular disease, extreme hypoxia, leukemia and HIV.Red and white retinal spots were first observed in 1872 by Swiss physician Moritz Roth, and named "Roth spots" six years later by Moritz Litten. They are typically observed via fundoscopy (using an ophthalmoscope to view inside the eye) or slit lamp exam.The original retinal spots identified in 1872 were attributed to nerve-fibres that had burst. Present-day analysis shows that they can be composed of coagulated fibrin including platelets, focal ischaemia, inflammatory infiltrate, infectious organisms, or neoplastic cells. Cause
Roths spots occur in conditions that predispose to endothelial damage of retinal capillaries, that is when there is dysfunction and disruption of the endothelium of retinal capillaries. Looking through the microscope reveals lesions with white centers made mainly of fibrin, depicting a fibrin-platelet plug at the site of vessel damage. Associated conditions
Conditions associated with Roths spots include:

Infective endocarditis
Anaemia/thrombocytopenia
Collagen vascular disease
Leukemia
Hypertensive retinopathy
Diabetic retinopathy
Pre-eclampsia
Human Immunodeficiency Virus (HIV)
Extreme hypoxia
Shaken-baby syndromeand also:
Candida albicans infection
vascular diseases
kala azar

Prevalence
Roths spots occur in only 5% of people with infective endocarditis. Litten, however reported a figure of 80%. See also
Oslers nodes
Janeway lesion
Splinter haemorrhage

References
External links
Image from the New England Journal of Medicine: Endocarditis
Image from the New England Journal of Medicine: CML