9 August 2008

Does Abilify affect testosterone?

Does Abilify affect testosterone?

Rimma Orenman

Hi Mark,

Thanks for your question.

Aripiprazole (Abilify) is a medication that is prescribed as a treatment (in combination with other medications) for schizophrenia, bipolar mania, and major depressive disorder. It has many of the side-effects which may occur with other medications of the same type (dopamine antagonists), such as somnolence, “extrapyramidal” disorders (such as prolonged muscle contractions, stiffness, and restlessness). Another side-effect of aripiprazole as well as of other similar medications is that they increase the amount of prolactin in the body. This is a naturally occurring hormone which causes breast tissue and milk production to increase during pregnancy. Levels of prolactin in the blood may increase in people taking aripiprazole, although the amount of increase seems to be too small to cause any clinically significant effects (i.e. they would not be noticed by the person taking the medication). However, an increase in prolaction can cause a decrease in libido, weaker erections, gynecomastia (growth in breast tissue), and galactorrhea (the production of milk from the breasts in the absence of pregnancy). You have to keep in mind that not all medications in this category will cause the same increase in prolactin. You should ask your doctor to check your prolactin level, as well as discuss with him a potential change of medications if the prolactin is indeed high. Stopping your medication suddenly without telling your doctor could have devastating effects on your mental health.

Of note, this increase in prolactin does not affect testosterone levels. Therefore, as your medication is adjusted, the side-effects should go away. Another side-effect sometimes associated with antipsychotics is a relaxation of the bladder sphincter, therefore allowing sperm to get into the urine instead of being excreted in a normal ejaculate: this is called retrograde ejaculation. This side-effect, though it may cause temporary infertility- because not enough sperm is produced- does not cause long-term damage to the genital or urinary tract and does not affect your health in any way. To confirm the diagnosis, a urine sample after an orgasm should be collected and analyzed. This is again a reversible side-effect that can be managed through adjustment of your medication or change to another drug in the same class.

In summary, I have not found any data, either human or animal, that has shown a relationship between aripiprazole and testosterone. I am wondering if you would consider writing back to us with more information as to what particular side-effects of Abilify (aripiprazole) you are wondering about as we would be better equipped to answer a more specific question.

Rimma, for Alterheros.