Does Aripiprazole (Abilify) Cause Sexual Side Effects

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Sexual side effects can happen with most antipsychotic medications. In fact, it's a common reason why people stop taking them. And stopping antipsychotics can lead to worsening mental health symptoms.

But not all antipsychotics have the same risk of side effects. For instance, aripiprazole (Abilify) may have a lower risk for sexual problems than other antipsychotics. However, sexual side effects from aripiprazole are still possible.

Does aripiprazole cause sexual side effects?

Yes. Aripiprazole can cause unwanted sexual side effects, such as erectile dysfunction or lowered sex drive. But it's less likely to cause them than other antipsychotics.

The dose you take may affect whether you notice sexual side effects. Studies found that people taking about 15 mg of aripiprazole per day had little to no change in sexual side effects.

Aripiprazole can also increase sexual behaviors for some people (called hypersexuality). This is a rare side effect, but there are a growing number of case reports about it. Those taking more than 20 mg per day are more likely to experience hypersexuality.

Sexual side effects of aripiprazole for men

Aripiprazole doesn't commonly cause sexual side effects. But it's possible for men to experience the following:

• Decreased sexual desire

• Decreased arousal

• Trouble having orgasms

• Hypersexuality

• Erectile dysfunction

• Trouble with ejaculation

• Priapism (an erection that lasts too long) - more on this rare side effect later

Sexual side effects of aripiprazole for women

It's not common for women to experience sexual side effects with aripiprazole either. But when they do, the following could happen:

• Decreased sexual desire

• Decreased arousal

• Trouble having orgasms

• Hypersexuality

• Decreased vaginal lubrication

• Menstrual changes, such as irregular menstrual periods

How common are sexual side effects with aripiprazole?

Sexual difficulties aren't common aripiprazole side effects. And in some cases, this medication can actually help improve sexual side effects caused by other antipsychotic medications.

Antipsychotic medications primarily work by balancing the activity of dopamine in the brain. But many antipsychotics raise levels of the hormone prolactin as a side effect. Experts believe that antipsychotics that raise prolactin levels are more likely to cause sexual side effects.

Aripiprazole only partially affects dopamine and doesn't increase prolactin levels. It also lowers high prolactin levels caused by other medications. This is likely why it can be helpful for people experiencing these side effects from other antipsychotics.

Do sexual side effects from aripiprazole go away?

More information is needed to fully understand sexual side effects caused by aripiprazole and other antipsychotics. Some studies suggest that these side effects may go away on their own, while other studies say that they're unlikely to go away or get better at all. So it's a good idea for you and your prescriber to discuss a plan on how to address any sexual issues that may occur.

If these side effects are too bothersome, your prescriber may suggest switching you to another medication. But don't stop taking aripiprazole without your prescriber's OK. This can cause withdrawal symptoms and worsen your mental health condition.

How can you manage sexual side effects from aripiprazole?

If you're experiencing sexual side effects from aripiprazole, be open and honest about it with your mental healthcare team. They can suggest ways to help manage these issues. What works for one person may not work for another. So it may take some trial and error to find the strategies that work best for you.

Options that can help reduce or treat sexual side effects from aripiprazole may include:

• Taking erectile dysfunction medications, such as sildenafil (Viagra) or tadalafil (Cialis)

• Attending individual psychotherapy

• Engaging in sex therapy or couples therapy

• Practicing stress-reducing activities, such as yoga or mindfulness

• Setting aside time to be intimate with your partner

• Reading books about sex, such as educational books or erotic fiction

• Creating a space in your home where you can safely and privately engage in sexual activities

When to seek emergency care for sexual side effects

Very rarely, men taking aripiprazole have experienced priapism. Priapism is an erection that lasts for 4 hours or longer. It's a medical emergency and requires immediate care. If your erection is painful or has lasted for 4 hours or more, go to the nearest ER. Priapism can cause permanent damage to the penis if it's not treated quickly.

Hypersexual behavior is another potentially serious sexual side effect of aripiprazole. There are reports of people taking aripiprazole who experienced an increase in impulsive behaviors, such as compulsive shopping and uncontrollable sexual behaviors. Certain people may have a higher risk of developing these side effects. These include people living with bipolar disorder and those with a history of substance use disorder.

Hypersexuality can significantly impact some people's daily lives and personal relationships. You should contact your mental healthcare team if you experience sexual behaviors that you can't control. In reported cases, hypersexual behaviors disappeared in a few weeks after people stopped or decreased their aripiprazole dose. But you shouldn't stop taking aripiprazole on your own.

Is aripiprazole less likely to cause sexual side effects than other antipsychotics?

Yes. Aripiprazole is less likely to cause sexual side effects than most other antipsychotic medications. As mentioned above, this is likely due to aripiprazole's effects on the hormone prolactin. But everyone's experience is unique. So if you find that aripiprazole causes bothersome sexual side effects, let your prescriber know.

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