From the Research
Abilify (aripiprazole) is generally not associated with hyperprolactinemia and may actually help reduce elevated prolactin levels. Unlike many other antipsychotic medications that commonly cause hyperprolactinemia (such as risperidone, haloperidol, and olanzapine), Abilify has a unique mechanism of action as a partial dopamine agonist. Most antipsychotics block dopamine receptors completely, which removes the inhibitory effect of dopamine on prolactin secretion and leads to increased prolactin levels. However, Abilify maintains some dopamine activity at the receptor, which helps preserve the normal inhibition of prolactin release.
Some key points to consider:
- Aripiprazole has been shown to be effective in reducing prolactin levels in patients with antipsychotic-induced hyperprolactinemia 1.
- A recent systematic review and network meta-analysis found that aripiprazole was effective in reducing prolactin levels in patients with hyperprolactinemia, particularly those with antipsychotic-induced or antidepressant-induced hyperprolactinemia 2.
- Another study found that adjunctive aripiprazole was statistically significantly effective in treating elevated serum prolactin levels in six randomized controlled trials 1.
- The evidence suggests that Abilify may be a good alternative treatment option for patients who have experienced hyperprolactinemia with other antipsychotic medications.
In terms of management options, the following may be considered:
- Reducing the dose of the offending antipsychotic
- Discontinuing the antipsychotic
- Switching to another antipsychotic associated with a lower risk of hyperprolactinemia, such as Abilify
- Adjunctive treatment with dopamine agonists, such as cabergoline or bromocriptine 3
Overall, Abilify (aripiprazole) is a good option for patients with hyperprolactinemia, particularly those with antipsychotic-induced or antidepressant-induced hyperprolactinemia, due to its unique mechanism of action and effectiveness in reducing prolactin levels. However, individual responses can vary, and monitoring prolactin levels may still be appropriate when clinically indicated.