Inverse dose-dependent effects of aripiprazole on sexual dysfunction and prolactin levels in patients with schizophrenia

Aripiprazole, with its distinct pharmacodynamic profile, acts as a partial agonist at dopamine D₂ and serotonin 5-HT_1A receptors and an antagonist at 5-HT_2A receptors, offering a superior safety profile compared to other antipsychotic drugs. The aim of this study was to assess the dose-dependent effects of aripiprazole on sexual dysfunction and prolactin levels in patients with schizophrenia. Patients receiving aripiprazole were recruited for this study. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS), and sexual dysfunction was evaluated with the Arizona Sexual Experiences Scale (ASEX). Fasting blood samples were collected to measure prolactin levels. A total of 128 patients with schizophrenia were recruited, comprising 86 females and 42 males. The prevalence of hyperprolactinemia, hypoprolactinemia, and sexual dysfunction was 12.5%, 47.6%, and 39.1%, respectively. Patients with sexual dysfunction had significantly higher prolactin levels and a higher prevalence of hyperprolactinemia compared to those without sexual dysfunction. Prolactin levels were significantly correlated with ASEX scores and aripiprazole dose. Multivariate regression analysis revealed that aripiprazole dose and ASEX scores were associated with prolactin levels. Aripiprazole exhibited inverse dose-dependent effects on prolactin levels and ASEX scores in patients with schizophrenia. Prolactin levels were positively correlated with ASEX scores, suggesting an association between prolactin and sexual dysfunction. Both aripiprazole dosing and its effects on prolactin levels may be influenced by sex differences.