Change in sexual dysfunction with aripiprazole: a switching or add-on study

J Psychopharmacol. 2008 May;22(3):244-53. doi: 10.1177/0269881107082901.


Sexual dysfunction and raised prolactin are common adverse effects of many anti-psychotics. Aripiprazole is an atypical anti-psychotic associated with a reduction in prolactin level in anti-psychotic-induced hyperprolactinemia. Our hypothesis was that switching from another anti-psychotic to aripiprazole would be associated with a reduction in sexual dysfunction. An open label switch to aripiprazole was offered to 27 subjects with inadequate therapeutic response or intolerance to another anti-psychotic, who were followed up for 26 weeks. Serial clinical ratings included the Anti-psychotic Non-Neurological Side-Effects Rating Scale (ANNSERS), and the Sexual Functioning Questionnaire. Our primary analysis point was week 12. In both sexes, there was a significant reduction in prolactin by week 12 (P = 0.003), accompanied by a significant improvement in libido (P = 0.028). In males, both erectile and ejaculatory difficulties were also significantly reduced (P = 0.04 and P = 0.017, respectively). In females, menstrual dysfunction was also significantly reduced at week 12 (P = 0.04). By week 26, the changes in all of the above remained significant, and were accompanied by a significant increase in satisfaction in overall sexual functioning (P = 0.007), despite the fact that 54.5% of subjects at were also taking their original antipsychotic. There was also a significant decrease in the total ANNSERS score (P < 0.001) and a significant improvement in all other measures of psychopathology (PANSS, CGI-S/I, GAF-S/D, and QoL). We conclude that switching to aripiprazole or the addition of aripiprazole to another antipsychotic regime is associated with a reduction in sexual dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Aripiprazole
  • Ejaculation / drug effects
  • Erectile Dysfunction / chemically induced
  • Erectile Dysfunction / psychology
  • Female
  • Humans
  • Hyperprolactinemia / chemically induced
  • Libido / drug effects
  • Male
  • Menstruation Disturbances / chemically induced
  • Middle Aged
  • Piperazines / adverse effects*
  • Piperazines / therapeutic use
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / complications
  • Psychotic Disorders / drug therapy
  • Quinolones / adverse effects*
  • Quinolones / therapeutic use
  • Sex Characteristics
  • Sexual Dysfunction, Physiological / chemically induced*
  • Sexual Dysfunction, Physiological / diagnosis
  • Sexual Dysfunction, Physiological / psychology
  • Surveys and Questionnaires


  • Antipsychotic Agents
  • Piperazines
  • Quinolones
  • Aripiprazole