[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-460464-105":59,"doc-detail-460464-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","sexual-reactivation-under-aripiprazole-in-schizophrenia-a-note-for-prescribers","Sexual reactivation under aripiprazole in schizophrenia - a note for prescribers","","A 29-year-old man with schizophrenia experienced complete sexual anhedonia while stable on risperidone 6 mg/day, with elevated serum prolactin (72 ng/mL). After gradual risperidone tapering and initiation of aripiprazole 10 mg/day, he reported abrupt return of sexual desire, frequent morning erections, and renewed masturbation within 4 weeks, initially producing intrusive distress and anxiety. Over subsequent weeks, arousal and affective engagement stabilized, aripiprazole dose was increased to 15 mg/day at week six, prolactin normalized (17 ng/mL), and relational capacity improved without adverse effects. The case highlights paradoxical sexual reactivation under aripiprazole and its potential clinical significance, supported by proposed dopaminergic receptor mechanisms and safety considerations regarding impulse-related behaviors.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/sexual-reactivation-under-aripiprazole-in-schizophrenia-a-note-for-prescribers/460464/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/sexual-reactivation-under-aripiprazole-in-schizophrenia-a-note-for-prescribers/460464.png","ImageObject",300,407,{"name":92,"@type":93},"Jiven","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What prompted the switch from risperidone to aripiprazole in this case?","Question",{"text":112,"@type":113},"Risperidone was gradually tapered due to emotional flattening and metabolic side effects, while persistent negative symptoms and complete sexual anhedonia were present.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How quickly did sexual function return after starting aripiprazole?",{"text":117,"@type":113},"Within 4 weeks, the patient spontaneously reported sudden return of sexual desire, frequent morning erections, and resumption of masturbation.",{"name":119,"@type":110,"acceptedAnswer":120},"What happened to prolactin levels and overall affective functioning during follow-up?",{"text":121,"@type":113},"Prolactin normalized by week 10, and the patient reported improved affective reactivity and relational capacity, starting a romantic relationship with manageable emotional and physical intimacy.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460464,1790758563,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":39,"preview_page_count":4},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","OPEN ACCESS | Psychopharmacology for the Clinician  \nSexual reactivation under aripiprazole in schizophrenia: a note for prescribers  \n  b  \nTheo Korchia a and Lena Palaniyappan  \naAix-Marseille University, Marseille, Provence-Alpes-Côte d’Azur, France; bWestern University, London, Ontario, Canada Corresponding author: Theo Korchia (email: [t.korchia@hotmail.fr](t.korchia@hotmail.fr))  \nA 29-year-old man with schizophrenia, stable for over 3 years on risperidone 6 mg/day, presented with persistent negative symptoms, pronounced emotional blunting, and complete sexual anhedonia. He reported no libido, no arousal, and no sexual activity. Serum prolactin was elevated (72 ng/mL) . Due to emotional flattening and metabolic side effects, risperidone was gradually tapered and aripiprazole 10 mg/day was initiated.  \nAfter 4 weeks, the patient spontaneously reported a sudden return of sexual desire, frequent morning erections, and resumed masturbation. This unexpected reactivation of sexual function, emerging rapidly after the switch, was initially experienced as intrusive and overwhelming, and caused him significant anxiety, as he described feeling “overstimulated” and unsure how to manage the intensity of his libido. Yet, from a clinical perspective, this phenomenon marked a turning point: a clear disruption of the previous emotional and motivational deadlock. Over the following 2 weeks, the sexual drive gradually stabilized, and he began to experience these changes as physiological and appropriate.  \nAt week six, aripiprazole was increased to 15 mg/day due to residual apathy and diminished emotional engagement. Interestingly, the improvement in sexual drive preceded and seemed to herald a broader affective reawakening. By week 10, the patient reported a clear improvement in affective reactivity and relational capacity. He had initiated a romantic relationship and described experiencing emotional and physical intimacy as both rewarding and manageable. Prolactin levels had normalized (17 ng/mL), and no adverse effects were observed.  \nThis case illustrates a paradoxical but increasingly reported phenomenon: sexual reactivation under aripiprazole. While sexual dysfunction is widely accepted as a side effect of antipsychotics and present in more than half of patients with schizophrenia,1 its reemergence as hypersexuality often triggers clinical discomfort, uncertainty, or even pathologization—yet it may signify an early step in emotional or motivational recovery. In this case, the improvement likely reflects a combined effect of risperidone discontinuation with normalization of prolactin levels, together with the direct pharmacodynamic properties  \nof aripiprazole. The relatively long half-life of aripiprazole may also contribute to the sustained course of these changes.  \nAripiprazole’s unique pharmacodynamic profile—partial agonism at D2 and 5-HT1A receptors, combined with 5-HT2A antagonism—may help explain its dual potential to both normalize sexual function2 and, in some cases, dysregulate it.3 Importantly, evidence suggests that following prior exposure to potent D2 antagonists, such as risperidone, compensatory receptor upregulation may enable aripiprazole to exert nearfull agonist activity at D2 sites.4 This enhanced dopaminergic stimulation may underlie the abrupt emergence of hypersexuality or other impulse-related behaviors observed in some patients. Indeed, beyond sexual reactivation, aripiprazole has been associated with impulse control disorders, including pathological gambling, compulsive shopping, and binge eating.5–7 Regulatory authorities have also issued safety communications highlighting these risks,8 , 9 underscoring the need for clinicians to anticipate and contextualize such phenomena within the broader spectrum of dopaminergic reactivation. Unlike most antipsychotics, which exert strong dopaminergic blockade, aripiprazole exerts a stabilizing effect on dopaminergic tone, allowing for a partial restoration of activity i","cbCaikgAW3VnSLqP","https://ap.wps.com/l/cbCaikgAW3VnSLqP","pdf",180439,"English","# Clinical case\n## Medication switch and timeline of sexual and affective changes\n## Prolactin normalization and tolerability\n# Clinical implications and mechanism\n## Proposed pharmacodynamic explanations\n## Dopaminergic reactivation and impulse-control risks","[{\"question\":\"What prompted the switch from risperidone to aripiprazole in this case?\",\"answer\":\"Risperidone was gradually tapered due to emotional flattening and metabolic side effects, while persistent negative symptoms and complete sexual anhedonia were present.\"},{\"question\":\"How quickly did sexual function return after starting aripiprazole?\",\"answer\":\"Within 4 weeks, the patient spontaneously reported sudden return of sexual desire, frequent morning erections, and resumption of masturbation.\"},{\"question\":\"What happened to prolactin levels and overall affective functioning during follow-up?\",\"answer\":\"Prolactin normalized by week 10, and the patient reported improved affective reactivity and relational capacity, starting a romantic relationship with manageable emotional and physical intimacy.\"}]","Sexual reactivation under aripiprazole in schizophrenia - a note for prescribers | PDF"]