RESUMO
AIM: A wide range of psychotropic drugs has been reported to affect human sexual functioning. Most of the literature regarding the relationship between sexual function and psychotropic drugs deals with antidepressants-induced sexual side effects, mainly due to SSRIs. Lithium is a first-line long-term treatment for mood disorders, primarily bipolar disorder; unfortunately, there are a limited number of studies specifically concerning sexual side effects in patients on long-term lithium treatment. MATERIALS AND METHODS: The present study concerns fifty-one clinically stable outpatients of both sexes (M=24, 47.1%; F=27, 52.9%), mean age 33.1+/-11.5 yrs, affected by bipolar I/II disorder according to DSM IV-TR criteria, submitted to long-term lithium treatment alone, compared to 176 healthy subjects (M=96, 54.5%; F=80,45.5%), mean age 30.2+/-8.7 yrs, as control group. Patients and controls were submitted to a questionnaire purposely developed for the study. RESULTS: A significantly higher percent of patients with respect to controls reported to have "never" or "rarely" sexual intercourses (45% vs 20%), sexual fantasies (25.4% vs 13.6%), and desire (37.3% vs 9.5%); moreover, a significantly lower amount of patients with respect to controls reported pleasure (73% vs. 91%) and satisfaction (57% vs. 83%) during intercourses. 18% of patients reported a worsening in sexual life after the onset of bipolar disorder; 30% of patients related their sexual problems to the introduction of lithium treatment. CONCLUSIONS: Notwithstanding the interpretative limits given by the use of questionnaires, our data seem to confirm even in patients under monotherapy, the negative influence of lithium on sexual excitation and desire, already depicted in patients with bipolar disorder under polytherapy.