In 2016, the United States Food and Drug Administration (FDA) released a warning statement regarding increased impulse control problems in patients receiving aripiprazole including compulsive eating, shopping, and sexual actions. In addition, discontinuation of aripiprazole decreased hypersexuality symptoms within a few weeks to a month. In these cases, hypersexuality symptoms arose days to weeks after administration of the medication. There are case reports in the literature of hypersexuality following aripiprazole treatment. Aripiprazole, however, has an agonist activity at the dopamine receptor which can induce compulsive behaviors such as gambling, shopping, and hypersexuality. Many antipsychotics also have sexual side effects as they block dopamine receptors which increase prolactin levels causing decreases in libido. However, it is associated with lower extrapyramidal and metabolic symptoms compared to other antipsychotics. Common side effects include akathisia, secondary Parkinsonism, and acute dystonia. Aripiprazole is often favored compared to other antipsychotics due to its lower side effect profile. It is also a partial agonist at the 5-HT1A receptor and antagonist at the 5-HT2A receptor. It has unique properties compared to other antipsychotics as it is a partial agonist at the dopamine D2 receptor. IntroductionĪripiprazole is a second-generation antipsychotic commonly used to treat schizophrenia and bipolar disorder. Clinicians should be aware of compulsive behaviors including hypersexuality with aripiprazole use and consider discontinuation of aripiprazole treatment in patients suffering from hypersexuality. Cessation of the aripiprazole led to a reduction in hypersexual behaviors. The case presented is of a 24-year-old male with schizophrenia who developed hypersexuality symptoms after initiation of aripiprazole. Aripiprazole is an antipsychotic with partial agonist activity at the dopamine D2 receptor which may lead to compulsive behaviors including hypersexuality.
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