Interactions Between Abilify and Testosterone Therapy in Transgender Individuals

Key Considerations for Combined Use

The American College of Physicians recommends that testosterone therapy in transgender men may increase blood pressure, hematocrit, triglycerides, and low-density lipoprotein cholesterol levels, while decreasing high-density lipoproteins 1, 2
Despite these changes in risk factors, studies show contradictory data regarding actual cardiovascular outcomes in transgender men on testosterone therapy, with no significant difference in cardiovascular mortality compared to the general population 2
Regular cardiovascular monitoring is essential, particularly for patients with pre-existing risk factors, as recommended by the American Heart Association 3, 4

Testosterone therapy can cause erythrocytosis in transgender men, with hemoglobin typically increasing to the male reference range within 3 months of starting therapy, according to the American Society of Hematology 3, 4
To reduce risks associated with erythrocytosis, clinicians should recommend smoking cessation, weight loss if BMI is high, and consider switching to a transdermal route of testosterone administration if issues arise, as suggested by the Endocrine Society 2

For transgender individuals on hormone therapy for more than 1 year, laboratory values should generally be interpreted based on their affirmed gender, as recommended by the American College of Clinical Endocrinologists 5
Cystatin C may be preferred over creatinine for evaluating kidney function in transgender individuals on hormone therapy, as it is less dependent on muscle mass, according to the National Kidney Foundation 5

Aripiprazole is commonly used to treat various psychiatric conditions, while testosterone therapy has been shown to improve dysphoria, quality of life, and psychological functioning in transgender individuals, as reported by the American Psychiatric Association 3
Monitoring for changes in mood, anxiety, and other psychiatric symptoms is important when using these medications together, as recommended by the American Psychological Association 3

Baseline assessment before starting combined therapy should include complete blood count, liver function, lipid profile, glucose, and baseline hormone levels, as recommended by the American Association of Clinical Endocrinologists 6

Testosterone dosing should be monitored to maintain levels in the typical physiological range for cisgender men (300-1,000 ng/dL), as suggested by the Endocrine Society 2

For transgender individuals with pre-existing cardiovascular conditions, more frequent monitoring may be necessary, as recommended by the American College of Cardiology 4
If erythrocytosis develops, consider adjusting the testosterone dose or changing the route of administration, as suggested by the American Society of Hematology 2
In cases of significant cardiovascular risk, the benefits of continued testosterone therapy should be weighed against potential risks, as recommended by the American Heart Association 3, 4