Lithium and sexual dysfunction: An under-researched area

Objective Lithium treatment remains an important part of the management of many patients with bipolar disorder, but the incidence of treatment-emergent sexual dysfunction with lithium is uncertain, and little is known about how it might be managed. Method Systematic computerised literature search of preclinical and clinical studies. Results Thirteen relevant papers were identified. Preclinical studies suggest lithium can reduce testosterone levels and impair nitric oxide mediated relaxation of cavernosal tissue. Clinical reports suggest lithium may reduce sexual thoughts and desire, worsen erectile function and reduce sexual satisfaction. Concomitant benzodiazepine prescription with lithium is associated with an increased risk of sexual dysfunction. Sexual dysfunction during lithium treatment appears significantly associated with a lower level of overall functioning and may reduce compliance. Conclusion The findings of this systematic review reveal the paucity of information about the incidence, associated factors and management of sexual dysfunction with lithium treatment and highlight the need for well-designed studies in this area.</p

Lithium therapy effects on the reproductive system

The chemical properties of lithium (Li) make it an extremely active substance in the body. It is active in the form of Li+ ion, so all salts have the same pharmacological action. Li salts are used to treat manic-depressive disorders (bipolar affective disorders), depressive manic symptoms that include hurried speech, hyperactivity, little need for sleep, aggression, and cholera. Li is a mood stabilizer and reduces extreme behaviors by restoring the balance of neurotransmitters in the brain. The modifications of the cAMP signaling pathway, alterations in the phosphoinositol pathway, variations in the availability of GABA and glutamate are some described mechanisms of action of Li to achieve its antimanic and mood stabilizing effects. Thus, lithium exerts modifications on the circadian rhythm, neurotransmission processes in the central nervous system, and neuroendocrine functions.Li therapies have benefits that have not yet been overtaken by other drugs. However, there is also some resistance to using these drugs, partly due to the lack of knowledge of the real impact of its adverse effects although some of them are reversible with the discontinuation of treatment. However, less known and more controversial are the toxic effects of lithium therapy on the reproductive system and, therefore, on human sexual functions. Studies in human and laboratory animals on the effects of Li have demonstrated significant effects on the functioning of the hypothalamic-pituitary gonadal axis. Therefore, this ion may alter human reproduction.Fil: Filippa, Veronica Palmira. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis; Argentina. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Departamento de Bioquímica y Ciencias Biológicas; ArgentinaFil: Mohamed, Fabian Heber. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Departamento de Bioquímica y Ciencias Biológicas; Argentin