Understanding the Connection: Does Aripiprazole Cause UTI?

October 12, 2025 •

4 min read

While aripiprazole itself does not directly cause urinary tract infections (UTIs), a significant body of evidence from case reports and clinical studies indicates that it can induce urinary retention, a condition known to increase UTI risk. This indirect link is a crucial piece of information for patients and prescribers.

Quick Summary

Aripiprazole does not directly cause UTIs but may increase risk by inducing urinary retention, a known precursor to infection. This is a rare side effect documented in some case studies. The risk is tied to the medication's effect on various receptors involved in bladder function.

Key Points

Indirect Cause: Aripiprazole does not directly cause UTIs but can cause urinary retention, which increases the risk of infection.
Mechanism of Action: The link is primarily pharmacological, involving the medication's effect on dopamine, serotonin, and adrenergic receptors that regulate bladder function.
Rare Side Effect: Urinary retention is a rare but documented side effect of aripiprazole, especially when compared to older antipsychotics.
Risk Factors: The risk is potentially higher in specific populations, such as the elderly, who may be more susceptible to urinary issues.
Combined Medications: Taking aripiprazole alongside certain antidepressants has been observed in some case reports involving urinary problems.
Monitor for Symptoms: Patients should watch for difficult urination, a feeling of incomplete bladder emptying, or signs of infection like fever, and report them promptly to a doctor.

The Indirect Link: From Aripiprazole to UTI

Aripiprazole, commonly known by the brand name Abilify, is an atypical antipsychotic used to treat conditions like schizophrenia, bipolar disorder, and major depressive disorder. While it is generally well-tolerated, some patients experience urinary side effects, which, though not directly causing an infection, can create conditions favorable for one. The primary mechanism is thought to be urinary retention, where the bladder fails to empty completely. When urine remains in the bladder, it provides a warm, moist environment where bacteria can multiply, significantly raising the risk of a UTI.

The Pharmacological Mechanism Behind Urinary Retention

Unlike older antipsychotics whose anticholinergic effects directly cause urinary retention, aripiprazole's action is more complex. Research suggests its impact on the bladder is mediated by its activity at several neurotransmitter receptors. These include dopamine D2 receptors, serotonin 5-HT1A receptors, and adrenergic $\alpha_1$ receptors, all of which play roles in the complex process of micturition (urination). Aripiprazole's partial agonistic activity at some of these receptors and antagonistic activity at others can disrupt the coordination between the bladder muscles and the urethral sphincter, leading to incomplete bladder emptying.

Clinical Observations and Case Reports

Numerous case reports have documented instances of aripiprazole-induced urinary retention. One notable case involved a 32-year-old male with schizophrenia who developed acute urinary retention after his aripiprazole dosage was increased. Symptoms resolved after the medication was discontinued. Another report highlighted urinary incontinence in a 49-year-old female shortly after starting aripiprazole, which also resolved upon discontinuation. These and other instances indicate that while uncommon, this side effect is a valid clinical concern.

In addition to individual case reports, larger studies of antipsychotic use have also revealed a link to UTIs, particularly in vulnerable populations. For instance, cohort studies in older adults have shown an increased risk of UTIs associated with antipsychotic use, especially within the first few weeks of starting treatment. While these studies don't isolate aripiprazole, they support the connection between antipsychotic-induced urinary dysfunction and subsequent infection risk.

What to Watch For

If you or someone you care for is taking aripiprazole, it is important to be aware of the signs of urinary issues that could precede a UTI. The symptoms can range from subtle to severe:

Voiding difficulties: Trouble starting urination, a weak stream, or an interrupted flow.
Incomplete emptying: A persistent feeling that the bladder is not empty after urinating.
Frequent urination: The need to urinate more often than usual.
Painful urination (dysuria): A burning sensation during or after urination.
Lower abdominal discomfort: A feeling of pressure or fullness in the pelvic area.
Signs of infection: These include fever, chills, cloudy or strong-smelling urine, and lower back or side pain.

It is essential to contact a healthcare provider immediately if these symptoms appear, as early intervention can prevent complications.

Aripiprazole vs. Other Antipsychotics: Urinary Side Effects

To put aripiprazole's urinary side effects into perspective, it can be useful to compare it with other antipsychotic medications. While urinary retention is a rare side effect of aripiprazole, it is generally less common than with some older antipsychotics, which are more potently anticholinergic.


Feature	Aripiprazole (Atypical)	Older Antipsychotics (e.g., Haloperidol, Thioridazine)	Other Atypicals (e.g., Clozapine)
Incidence of Urinary Retention	Rare	More common, especially with low-potency types	Moderate to high; clozapine is well known for urinary side effects
Anticholinergic Effect	Low affinity for muscarinic receptors	Strong anticholinergic properties	Variable; some have stronger anticholinergic effects than aripiprazole
Mechanism of Urinary Dysfunction	Likely due to partial agonism at D2 and 5-HT1A receptors, and $\alpha_1$ antagonism	Direct anticholinergic action is a primary cause	A combination of anticholinergic and other effects
UTI Risk via Retention	Possible due to rare urinary retention	Higher risk due to more frequent urinary retention	Variable; depends on the specific drug's effect on bladder function

Conclusion

To conclude, while the statement does aripiprazole cause UTI? is technically inaccurate, the medication can indirectly increase the risk of a UTI by causing urinary retention in rare cases. For most patients, aripiprazole's effect on the urinary system is not a concern. However, for those who experience voiding difficulties, the buildup of residual urine can lead to bacterial growth and infection. It is critical for patients, particularly the elderly, to monitor for any changes in urination patterns or symptoms of infection while on aripiprazole. Timely communication with a healthcare provider is the best way to address these symptoms and ensure effective, safe treatment.

For more detailed information on specific side effects and management, patients should consult their doctor or pharmacist and refer to resources like the U.S. National Library of Medicine's MedlinePlus.

Frequently Asked Questions

Yes, aripiprazole can cause problems with urination, though rarely. Side effects may include urinary retention (inability to completely empty the bladder), urgency, frequency, and, in some cases, incontinence.

Urinary retention is the inability to completely empty the bladder, while a UTI is an infection caused by bacteria in the urinary tract. Urinary retention can lead to a UTI because stagnant urine is a breeding ground for bacteria.

Urinary retention caused by aripiprazole is considered a rare adverse effect. Numerous clinical reviews and case reports have noted its infrequency, especially when compared to older antipsychotic medications.

While it can affect anyone, the risk may be higher in older adults and those with pre-existing conditions that affect bladder function. Some case studies have also noted issues when aripiprazole was taken concurrently with certain antidepressants.

If you experience painful or difficult urination, or have other signs of a possible infection like fever or chills, you should contact your doctor immediately. They can rule out other causes, check for an infection, and determine if adjusting your medication is necessary.

If aripiprazole causes urinary retention, it could potentially worsen an existing UTI by preventing the flushing of bacteria from the bladder. This is why it is crucial to address any urinary symptoms promptly.

In several reported cases, urinary issues including incontinence and retention resolved after the aripiprazole treatment was stopped or the dosage was lowered. However, any medication changes should only be made under the supervision of a healthcare provider.