Does Abilify Cause Erectile Dysfunction? The Truth About Aripiprazole

Abilify (aripiprazole) may lead to sexual side effects in some individuals, including erectile dysfunction. While not everyone experiences these effects, some people report changes such as reduced libido, difficulty achieving or maintaining an erection, delayed or absent orgasm, and in rare cases, priapism(a prolonged and painful erection lasting more than four hours).

The amount of aripiprazole you take can affect whether you experience sexual side effects. Research shows that people taking around 15 mg per day usually notice little to no changes in their sexual function.

In some cases, Aripiprazole can also increase sexual behaviors for some people (called hypersexuality[1]). 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 [2] are more likely to experience hypersexuality.

What Is Abilify (Aripiprazole)?

Aripiprazole or abilify is a medicine used to treat mental health conditions like schizophrenia, bipolar disorder, depression (along with antidepressants), autism-related irritability, and Tourette’s disorder. This may sound overwhelming at first, but let us break it down for you.

All these conditions- schizophrenia, bipolar disorder, depression, autism-related irritability, and Tourette’s disorder are mental health-related disorders that affect how a person thinks, feels, behaves, or reacts. Aripiprazole helps by balancing brain chemicals called hormones to manage symptoms like mood swings, hallucinations, aggression, and involuntary movements, improving daily functioning and emotional stability.

It works by helping to balance brain chemicals commonly called hormones, like dopamine and serotonin, which affect your mood, thoughts, and behavior.

Aripiprazole belongs to a group of medicines called antipsychotics, which are often used to help manage various mental health conditions.

It turned my drive off completely when I took it. Confessed by someone on Reddit [3]

How Aripiprazole Works in the Brain – Explained Simply

How exactly does Aripiprazole or Abilify work in the brain? Unlike many older medications that just block certain brain chemicals, aripiprazole or abilify takes a smarter, more balanced approach. Think of it like a dimmer switch instead of a simple on/off button. Here are a few complicated steps to understand how they work in an easy, simplified manner.

1. What Is Partial Agonism?

Aripiprazole connects to certain brain receptors [4] (dopamine and serotonin). Brain receptors are molecules on the brain surface that help brain cells communicate. But instead of turning brain receptors fully “on” or “off,” it gives them a gentle poke. This helps balance the brain’s activity, not too much, not too little.

2. How It Affects Dopamine (a brain chemical that affects mood, motivation, and thinking):

• In brain areas where there's too much dopamine [5] (like in psychosis), aripiprazole helps block some of it. This calms things down.
• In areas where there’s too little dopamine (like in depression or low motivation), aripiprazole helps boost it. This can improve mood and thinking.

So, it adjusts dopamine levels depending on what's needed in different parts of the brain.

3. How It Affects Serotonin (another brain chemical that affects mood and emotion):

• Aripiprazole blocks a certain serotonin [6] receptor (called 5-HT2A). This may help control dopamine levels better and add to its calming, stabilizing effect, keeping a check.

4. What Makes It Different from Other Medications?

Most older antipsychotic medications just block dopamine strongly, which can lead to side effects like stiffness, tremors (called extrapyramidal symptoms), or hormone problems like high prolactin [7]. Aripiprazole is gentler because it partly turns dopamine on and partly turns it off, so it tends to cause fewer side effects.

Side Effects of Abilify or Aripiprazole

Drugs or medications that treat brain problems are antipsychotic medications. Many antipsychotic medications [7]can affect hormone levels and brain chemicals, leading to sexual side effects in some people. However, Abilify (aripiprazole) is an "atypical" antipsychotic, meaning it works differently from older medications and is generally less likely to cause sexual problems.

While not everyone experiences these effects, men and women may experience different symptoms, which can be clearly seen from the following table. These side effects include:

1. Decreased Sexual Desire

You may feel less interested in sex or have fewer sexual thoughts. This is sometimes called a low libido. Seen in both men and women.

2. Decreased Arousal

Even if you're in the mood, your body might not respond as expected — for example, difficulty getting physically aroused or staying aroused. Seen in both men and women.

3. Trouble Having Orgasms

It might take longer than usual to reach orgasm, or you might not be able to have one at all, even if you're fully aroused. Seen in both men and women.

4. Hypersexuality (Increased Sexual Urges)

Some people may experience the opposite — an unusual increase in sexual thoughts or urges that may feel hard to control. Seen in both men and women.

5. Trouble Having an Erection (Erectile Dysfunction)

Men may have difficulty getting or keeping an erection firm enough for sex. Seen in men. [8]

6. Trouble with Ejaculation

Men may notice changes in how and when ejaculation happens; this could include delayed ejaculation or difficulty ejaculating at all. Seen in men.

7. Priapism (Painful, Long-Lasting Erection)

A rare but serious condition where an erection lasts for several hours and doesn’t go away. It can be painful and may need urgent medical attention. Seen in men. [9]

8. Decreased Vaginal Lubrication

For women, the vagina may not produce enough natural lubrication during arousal, making sex uncomfortable or painful. Seen in women.

9. Menstrual Changes

Women might notice irregular periods, lighter or heavier bleeding, or missed periods. Seen in women.

Compared to other antipsychotics, Abilify tends to cause fewer or milder sexual side effects, and in some cases, it may even improve sexual functioning, especially if the person had issues from previous medications. However, Abilify (aripiprazole) is a newer type of antipsychotic called an "atypical" antipsychotic. It works differently from older medications and is less likely to cause problems with sexual functioning. Some people may find that it causes fewer or milder side effects compared to other similar drugs.

How does it cause Side effects?

Abilify, like many other antipsychotic medications, works by changing the levels of certain brain chemicals, commonly called hormones, mainly dopamine and serotonin. These brain chemicals are important not just for your mood and thinking, but also for your sexual desire and response.

Here’s how it might affect your sex life:

1. Brain Chemicals and Desire

Dopamine and serotonin help control things like motivation, pleasure, and mood, which are all linked to your interest in sex. When Abilify changes these levels, it can sometimes lower your sex drive, arousal, or ability to have an orgasm.

2. Hormonal Changes

Some antipsychotic medications can raise a hormone called prolactin. Prolactin is a hormone primarily known for its role in lactation, the production of breast milk, in mammals. High prolactin levels can lead to problems like low libido, erectile dysfunction, irregular periods, or reduced vaginal lubrication. Abilify usually doesn't raise prolactin as much as other medications, and in some cases, it might even lower it, which is a good sign.

3. Physical and Emotional Effects

Sexual function isn’t just about the body; it’s also about how you feel. Abilify might interfere with both the physical side of sex (like getting aroused or reaching orgasm) and the mental/emotional side (like feeling in the mood or connected to your partner).

If you notice changes in your sex drive or performance after starting Abilify, don’t panic or suffer in silence. It’s a known effect, and there are ways we can work around it.

Can You Reduce Sexual Side Effects from Abilify?

Yes, in some cases, sexual side effects can be managed. Here are some possible options:

1. Give It Time

Your body might just need a few weeks to adjust. Some side effects go away on their own.

2. Lower the Dose

Sometimes, a lower dose can reduce side effects. But never change the dose without your doctor’s guidance.

3. Switch to Another Medication

If the side effects are too much, your doctor might suggest trying a different antipsychotic with fewer sexual side effects.

Here are a few options that may cause fewer sexual side effects:

Medication

What's it used for

Possible Side Effects

Olanzapine [10] (Zyprexa)

Bipolar disorder, schizophrenia

Sleepiness, weight gain, dry mouth, and constipation. It may be risky for older adults with dementia.

Clozapine [11] (Clozaril)

Severe schizophrenia

Drowsiness, weight gain, and dizziness. May cause serious blood or heart issues in some people.

Quetiapine [12] (Seroquel)

Bipolar disorder, schizophrenia

Sleepiness, dizziness, upset stomach, and weight gain. May increase suicidal thoughts in young people.

Can Abilify (Aripiprazole) Cause Erectile Dysfunction?

Abilify is less likely to cause sexual problems like erectile dysfunction, compared to many older antipsychotic medications. Studies show that people who switched from other antipsychotics to Abilify often had better sexual function. Some even had improvements in sex drive and erections after just a few months. [13] [14]

One big study found that men on Abilify had fewer sexual side effects than those on other medications like paliperidone. It also showed that Abilify lowered prolactin levels, a hormone that can affect sexual health.

That said, sexual side effects like low libido or trouble getting an erection can still happen with Abilify, but they’re usually less common. Many people don’t report these side effects because they feel embarrassed, so we may not know exactly how often they occur.

If you notice any changes in your sexual health while taking Abilify, talk to your doctor. You’re not alone, and there are ways to manage it. [15]

Using Abilify (Aripiprazole) for SSRI-Related Sexual Problems

Sometimes, people who take antidepressants [16] called SSRIs (like fluoxetine or sertraline) notice changes in their sex life, like lower desire, trouble getting aroused, or difficulty with erections.

In some cases, doctors add a small dose of Abilify (aripiprazole) to help. Research shows this can gently improve sexual interest, arousal, and even erections in some people.

It doesn’t work for everyone, but for some, it can make a noticeable difference. If your antidepressant is affecting your sex life, talk to your doctor. There may be ways to help without stopping the medication that’s helping your mood.

Summary Table: Aripiprazole and Sexual Function

Aspect

Aripiprazole (Abilify) Findings

Incidence of ED

Lower than most antipsychotics

Effect on Prolatin

Usually decreases or normalizes levels

Effect on Dopamine

Partial agonist; stabilizes dopaminergic tone [17]

Use in SSRI Sexual Dysfunction

Can improve sexual function as an adjunct

Individual/Dose/Duration

Effects vary; dose and duration matter  [18]

Rare Effects

Cases of hypersexuality reported

Conclusion: Should You Be Concerned About Abilify and Sexual Side Effects?

Abilify (aripiprazole) is generally considered one of the better-tolerated antipsychotics when it comes to sexual side effects. Compared to older medications, it causes fewer problems like erectile dysfunction, low libido, or hormonal imbalances. Some people experience improved sexual functioning after switching to Abilify from other antipsychotics.

That said, no medication is side-effect free. Abilify can still cause issues like ED, trouble with orgasm, or even rare cases of increased sexual urges (hypersexuality), especially at higher doses. Everyone reacts differently, and the effects can depend on your dose, duration of use, and your body’s chemistry.

If you notice any changes in your sexual health while on Abilify, don’t ignore them. You’re not alone, and there are ways to manage or reduce these effects. Talk openly with your doctor; they can help adjust the dose, explore alternatives, or offer solutions that work for you.

Your mental health matters. So does your sexual well-being. With the right guidance, you don’t have to sacrifice one for the other.