Adjunctive aripiprazole for amisulpride-induced hyperprolactinemia: a preliminary retrospective study showing no...

The potential of aripiprazole to reverse amisulpride-induced hyperprolactinemia has yet to be established.

To investigate whether adjunctive aripiprazole treatment can reverse amisulpride-induced prolactin (PRL) elevation.

This study was a single-arm retrospective cohort study.

We conducted a retrospective analysis of medical records from patients treated with amisulpride at a tertiary specialized psychiatric hospital, between June 1, 2022, and December 31, 2025, who subsequently received adjunctive aripiprazole. Data were collected via the electronic medical record system. A paired t-test was used to compare PRL values before (⩽7 days, PRL1) and after (⩾7 days, PRL2) aripiprazole initiation.

The difference between PRL1 and PRL2 was not statistically significant (mean difference = 4.115 ng/ml, 95% CI (-5.121, 13.351) ng/ml, SD = 15.284, p = 0.351, Cohen's d = 0.269, 95% CI for d (-0.290, 0.818)). Stratified analyses by sex and diagnosis yielded results consistent with the main analysis across subgroups (p > 0.05). None of the leave-one-out analyses altered the study's conclusions (all p-values > 0.05), indicating that the results were not driven by any single extreme value.

In individuals with amisulpride-related hyperprolactinemia, this retrospective study suggests that adjunctive aripiprazole has an insignificant therapeutic effect in reversing PRL elevation. Therefore, until more comprehensive research evidence becomes available, a cautious approach should be taken in clinical practice regarding the use of adjunctive aripiprazole to reverse amisulpride-induced PRL elevation.