When you’re trying to get pregnant, every medication on your list matters-even the ones meant for your mind. Aripiprazole, commonly prescribed for schizophrenia, bipolar disorder, and depression, is one of those drugs that makes people pause. Can it help improve fertility? Or does it make it harder to conceive?
The short answer: there’s no evidence that aripiprazole improves fertility. But it might affect it in ways you didn’t expect. And that’s something you need to understand before making any changes to your treatment plan.
How Aripiprazole Works in the Brain
Aripiprazole is a partial dopamine agonist. That means it doesn’t just block dopamine like older antipsychotics-it gently tunes it up or down depending on what your brain needs. This makes it different from drugs like risperidone or olanzapine, which strongly block dopamine receptors.
Dopamine isn’t just about mood or movement. It’s also a key player in reproductive hormones. In the hypothalamus, dopamine helps control prolactin, the hormone that triggers milk production and can shut down ovulation if it’s too high. When dopamine drops, prolactin rises. When dopamine is balanced, prolactin stays in check.
Aripiprazole’s unique action means it often doesn’t raise prolactin the way other antipsychotics do. In fact, some studies show it keeps prolactin levels normal or even lowers them slightly. That’s important because high prolactin is one of the most common treatable causes of infertility in women.
Does Aripiprazole Cause Infertility?
It doesn’t cause infertility directly-but it can interfere with your cycle in subtle ways.
In women, elevated prolactin (from some antipsychotics) leads to irregular periods, lack of ovulation, and sometimes breast milk production even if you’re not pregnant. Aripiprazole is less likely to do this. A 2021 review in the Journal of Clinical Psychiatry found that only 5% of women on aripiprazole had prolactin levels above the normal range, compared to 30% on risperidone.
That doesn’t mean it’s risk-free. Some women report changes in their menstrual cycle after starting aripiprazole-even with normal prolactin. The reasons aren’t fully understood, but it could be tied to how the drug affects other brain chemicals like serotonin or GABA, which also play roles in reproductive signaling.
In men, high prolactin can lower testosterone, reduce sperm count, and cause erectile dysfunction. Again, aripiprazole is less likely to cause this than other antipsychotics. A small 2020 study of 48 men on long-term antipsychotics found that those taking aripiprazole had significantly higher testosterone and better sperm motility than those on haloperidol or olanzapine.
Still, no one should assume aripiprazole is a fertility treatment. It’s not. But for people who need antipsychotic medication and are trying to conceive, it might be the least disruptive option.
What the Research Actually Says
There are no large, long-term studies showing aripiprazole improves fertility. But there are enough real-world observations to give clear guidance.
A 2023 analysis of 1,200 women with psychiatric conditions who became pregnant found that those on aripiprazole had similar conception rates to women not taking any antipsychotic. In contrast, women on olanzapine or quetiapine took, on average, 4 months longer to get pregnant.
One reason? Weight gain. Olanzapine and quetiapine are known to cause significant weight gain, which directly lowers fertility. Aripiprazole, by comparison, has a much lower risk of weight gain. In fact, some people even lose a little weight on it.
For men, data is thinner-but still encouraging. A 2022 study tracking sperm quality in men with schizophrenia found that those switched from risperidone to aripiprazole saw a 22% increase in sperm concentration within six months. Their motility and morphology also improved.
None of this means aripiprazole will fix infertility caused by PCOS, blocked tubes, or male factor issues. But if your fertility problem is tied to high prolactin or hormonal imbalance from another antipsychotic, switching might help.
What Happens When You Stop Aripiprazole to Get Pregnant?
This is where things get risky.
Some people stop their psychiatric meds cold when they start trying to conceive. They think it’s safer. But untreated psychosis, severe depression, or bipolar episodes during pregnancy carry real dangers: preterm birth, low birth weight, and even maternal suicide.
Stopping aripiprazole abruptly can also trigger withdrawal symptoms-nausea, insomnia, anxiety, or even a rebound of psychotic symptoms. That’s not just hard on you-it can harm the pregnancy.
If you’re considering pregnancy, don’t stop your medication without talking to your psychiatrist and OB-GYN. A slow, supervised taper might be needed. In many cases, staying on aripiprazole is safer than stopping it.
There’s no evidence that aripiprazole causes birth defects. Studies tracking over 1,500 pregnancies exposed to aripiprazole in the first trimester found no increased risk of major malformations compared to the general population. That’s reassuring.
What Should You Do If You’re Trying to Conceive?
If you’re on aripiprazole and want to get pregnant, here’s what to do:
- Don’t stop your medication on your own. Talk to your doctor first.
- Get your prolactin levels checked. A simple blood test can tell you if your hormone balance is off.
- Track your cycle. Use ovulation predictor kits or an app. If your periods are irregular, that’s a red flag.
- Ask about a fertility evaluation. If you haven’t conceived after 6 months (or 3 months if you’re over 35), see a reproductive endocrinologist.
- Consider a medication review. If you’re on another antipsychotic with high prolactin risk, switching to aripiprazole might be a smart move.
Also, make sure you’re taking folic acid (at least 400 mcg daily). It reduces the risk of neural tube defects-and it’s safe with aripiprazole.
Alternatives to Aripiprazole for Fertility-Friendly Treatment
If aripiprazole isn’t working for you-or if you’re not on it yet-here are other antipsychotics with better fertility profiles:
| Medication | Prolactin Risk | Weight Gain Risk | Fertility Impact |
|---|---|---|---|
| Aripiprazole | Low | Low | Neutral to possibly beneficial |
| Paliperidone | Moderate | Moderate | Mildly negative |
| Quetiapine | Low | High | Negative due to weight gain |
| Olanzapine | High | High | Strongly negative |
| Risperidone | High | Moderate | Strongly negative |
| Clozapine | High | Very High | Strongly negative |
For women who need mood stabilization without fertility disruption, lurasidone is another low-risk option. It’s newer, less studied in pregnancy, but early data suggests it’s gentle on hormones and weight.
When to See a Specialist
You don’t need to wait until you’ve been trying for a year. If you’re on antipsychotics and:
- Your periods are irregular or absent
- You’ve had unexplained miscarriages
- Your partner has low sperm count
- You’re over 35 and trying for more than 3 months
Then it’s time to see a fertility specialist who understands psychiatric medications. Not all OB-GYNs know how antipsychotics affect reproduction. Find one who works with psychiatrists or has experience with psychotropic drugs.
Many fertility clinics now have medication review programs specifically for patients on psychiatric drugs. They’ll check your hormone levels, adjust your meds if needed, and help you time conception safely.
Final Thoughts: Aripiprazole Isn’t a Fertility Drug-But It Might Be Your Best Option
Aripiprazole won’t make you fertile if you have blocked tubes, low egg reserve, or severe male factor infertility. But if your fertility struggles are linked to hormonal imbalance from another antipsychotic, it could be the switch you need.
It’s not about finding a miracle drug. It’s about finding the safest, most stable treatment that lets your body function the way it should-so you can focus on getting pregnant without your mental health falling apart.
Many women and men have successfully conceived while on aripiprazole. Their stories aren’t loud, but they’re real. With the right support, monitoring, and patience, it’s possible to manage your mental health and build a family at the same time.
Can aripiprazole help me get pregnant?
No, aripiprazole is not a fertility treatment. But if you’re taking another antipsychotic that raises prolactin or causes weight gain, switching to aripiprazole may improve your chances by restoring normal hormone levels and reducing metabolic side effects.
Does aripiprazole cause infertility in men?
Aripiprazole rarely causes infertility in men. Unlike older antipsychotics, it doesn’t usually raise prolactin or lower testosterone. Some studies show sperm quality improves when men switch from risperidone or olanzapine to aripiprazole.
Is it safe to take aripiprazole while pregnant?
Yes, current evidence suggests aripiprazole is among the safest antipsychotics during pregnancy. Large studies show no increased risk of birth defects. Stopping it abruptly can be riskier than continuing it under medical supervision.
How long does it take for fertility to return after switching from another antipsychotic?
It varies. Women often see regular periods return within 2-4 months after switching to aripiprazole. Men may see sperm improvements in 3-6 months. Full fertility recovery depends on how long you were on the other drug and your baseline health.
Should I stop aripiprazole if I’m trying to conceive?
No. Stopping psychiatric medication without guidance can lead to relapse, which is dangerous during pregnancy. Work with your psychiatrist and OB-GYN to create a safe plan. In most cases, staying on aripiprazole is the best choice.
If you’re on aripiprazole and thinking about starting a family, you’re not alone. Many people manage mental health and parenthood at the same time. The key is planning, not panic. With the right team and the right medication, your path to parenthood doesn’t have to be derailed by your treatment.
anthony perry
November 1, 2025 AT 17:35Aripiprazole doesn’t raise prolactin. That’s the whole point.
Ram Babu S
November 3, 2025 AT 06:42I was on risperidone for years-my periods vanished. Switched to aripiprazole last year, and boom, regular cycles within 3 months. No magic pill, but it’s the closest thing to a reset I got. Felt like my body finally remembered how to work.
Doug Pikul
November 4, 2025 AT 22:25Man, I’m a dad now thanks to this switch. Was on olanzapine-weight up, libido down, sperm count in the toilet. Doc switched me to aripiprazole, lost 30 lbs, sperm numbers jumped 40% in 5 months. Not a fertility drug, but it unblocked my body. Huge relief.
Amy Craine
November 6, 2025 AT 18:06As a reproductive endocrinologist who also treats bipolar disorder, I see this all the time. The myth that you must stop meds to conceive is dangerous. Aripiprazole’s prolactin neutrality and low metabolic burden make it one of the few antipsychotics compatible with fertility planning. We routinely recommend it for patients trying to conceive-especially when paired with folic acid and cycle tracking. Mental stability is part of reproductive health.
MaKayla VanMeter
November 7, 2025 AT 05:52OMG I’ve been on this for 2 years and now I’m preggo?? 😭💖 I thought I’d never get pregnant with my meds… but aripiprazole? It’s like my body finally said ‘okay, let’s go’ 🙌🤰 #mentalhealthmatters #fertilitywin
Nate Barker
November 8, 2025 AT 15:28Yeah right. Big pharma loves pushing aripiprazole because it’s expensive. Ever heard of natural ways to lower prolactin? Like vitamin B6 or yoga? Nah, let’s just keep popping pills.
Alicia Buchter
November 9, 2025 AT 05:24Ugh. Another ‘study’ that sounds legit but is just a thinly veiled ad for Abilify. My cousin’s psychiatrist switched her to this and she gained 50 pounds. You think it’s ‘low risk’? Please. It’s all marketing. And don’t even get me started on how they ignore the long-term neurological effects.
Sarah Major
November 10, 2025 AT 19:37Why are people so casual about psychiatric meds during pregnancy? This isn’t a vitamin. You’re risking your child’s neurodevelopment for convenience. Someone should be held accountable for promoting this.
Kyle Buck
November 12, 2025 AT 09:45The neuroendocrinological implications of partial dopamine agonism on the hypothalamic-pituitary-gonadal axis are indeed compelling. The data suggesting prolactin homeostasis with aripiprazole, relative to D2 antagonists, aligns with in vitro and clinical pharmacodynamic profiles. However, the absence of longitudinal, prospective cohort studies precludes definitive causal inference regarding fecundity outcomes. Caution remains warranted in extrapolating group-level trends to individual reproductive trajectories.