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Clinical evidence

Aripiprazole (prolactin-sparing)

D2 partial agonist·Medication side-effects · Sexual-dysfunction treatments

Effect across the cycle

DesireNeutral: Largely libido-sparing; can restore desire when switched from a prolactin-raising agent.
ArousalNeutral: Generally preserved.
PerformanceNeutral: Lower erectile impairment than typical antipsychotics.
ClimaxNeutral: Orgasmic function largely preserved.
ExperienceNeutral: Less reward blunting than high-D2-blockade agents.
MemoryNeutral: Not a memory factor.

Mechanism

Partial D2 agonist that lowers prolactin and is used to treat antipsychotic-induced hyperprolactinemia. Sexual dysfunction rates are far lower than prolactin-raising agents (~16–27% vs 40–60%), with inverse dose-dependent effects on prolactin and dysfunction.

Pharmacokinetics
Long half-life; prolactin-lowering effect sustained.
Reversibility
Can reverse hyperprolactinemia caused by other antipsychotics.

Sex differences & notes

Used as a switch or augmentation strategy to reverse antipsychotic sexual side effects.

Key sources

  • ScienceDirect — inverse dose-dependent aripiprazole SD/prolactin