Am J Psychiatry 1992; 149:801-805
Copyright © 1992 by American Psychiatric Association
Lithium, benzodiazepines, and sexual function in bipolar patients
AM Ghadirian, L Annable and MC Belanger
Allan Memorial Institute, Royal Victoria Hospital, Montreal, Que., Canada.
OBJECTIVE: Lithium and benzodiazepines are widely used in the treatment of
bipolar patients. Yet studies of the effect of these drugs on sexual
function are scarce. This study surveyed sexual function in bipolar
patients treated with lithium, either alone or in combination with other
drugs. METHOD: Sexual function was assessed by self-rating scale in 104
outpatients (45 men and 59 women) with a DSM-III diagnosis of bipolar
disorder who were attending an affective disorders clinic. All patients
were under treatment with lithium, either alone (35%) or in combination
with benzodiazepines (49%), tricyclic antidepressants (17%), neuroleptics
(17%), tryptophan (10%), or carbamazepine (1%). The patients were in a
stable and euthyroid state at the time of the assessment. Serum lithium and
plasma prolactin concentrations were measured at the same time. RESULTS:
Multiple regression analysis revealed an association between concomitant
benzodiazepine administration and sexual dysfunction scores. Difficulties
in sexual functioning were significantly more common in patients treated
with a combination of lithium and benzodiazepines (49%) than in those
treated with either lithium alone (14%) or lithium in combination with
other drugs (17%). No relationship was found between serum lithium or
plasma prolactin levels and sexual dysfunction scores. CONCLUSIONS:
Lithium, when given alone, did not appear to have a major effect on sexual
function, whereas its combination with benzodiazepines was associated with
sexual dysfunction in about half of the patients. More attention should be
given to drug-induced sexual dysfunction, since its presence can have
important consequences for clinical management and compliance.
