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Mood stabilizers impact sexual functioning in patients with bipolar disorder

02 May 2020

Lithium treatment, alone or in combination with benzodiazepines, worsen sexual function (SF) in patients with bipolar disorder (BD), a recent study has shown.

Researchers conducted a multicentre, cross-sectional investigation of 114 BD patients who received lithium alone (L group), anticonvulsants alone (A group), lithium with anticonvulsants (L+A group) or lithium with benzodiazepines (L+B group). SF was measured according to the Changes in Sexual Functioning Questionnaire Short Form (CSFQ-14).

SF was significantly worse in the L (odds ratio [OR], 0.31, 95 percent confidence interval [CI], 0.11–0.90; p=0.032) and L+B (OR, 0.27, 95 percent CI, 0.080–0.89; p=0.032) groups relative to the A group. Other risk factors for poor SF were being female (OR, 0.19, 95 percent CI, 0.079–0.45; p<0.001) and older age (OR, 0.94, 95 percent CI, 0.90–0.98; p=0.006).

In terms of sexual desire, lithium alone (OR, 0.26, 95 percent CI, 0.09–0.74; p=0.012) or with benzodiazepines (OR, 0.20, 95 percent CI, 0.06–0.64; p=0.007) yielded significantly more negative effects than anticonvulsants. Lithium alone had the same effect on sexual arousal (OR, 0.32, 95 percent CI, 0.11–0.89; p=0.029).

In turn, these effects on SF correlated with changes in quality of life. For example, higher sexual arousal was associated with better physical (OR, 2.18, 95 percent CI, 0.24–4.12; p=0.028) and mental (OR, 2.85, 95 percent CI, 0.99–4.71; p=0.003) component summary scores.

“In other words, mood stabilizers affect SF differently, and depending on the affected phase of SF, QoL is also affected differently,” the researchers said.

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