Elnazer Hesham Y, Sampson Anthony, Baldwin David
Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Hum Psychopharmacol. 2015 Mar;30(2):66-9. doi: 10.1002/hup.2457. Epub 2015 Jan 26.
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.
Systematic computerised literature search of preclinical and clinical studies.
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.
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.
锂盐治疗仍然是许多双相情感障碍患者治疗的重要组成部分，但锂盐治疗引发性功能障碍的发生率尚不确定，且对于如何处理这一问题知之甚少。
对临床前和临床研究进行系统的计算机文献检索。
共识别出13篇相关论文。临床前研究表明，锂盐可降低睾酮水平，并损害一氧化氮介导的海绵体组织舒张功能。临床报告表明，锂盐可能会减少性想法和性欲，使勃起功能恶化，并降低性满意度。锂盐与苯二氮䓬类药物联合处方会增加性功能障碍的风险。锂盐治疗期间的性功能障碍似乎与整体功能水平较低显著相关，并且可能会降低依从性。
本系统评价的结果揭示了关于锂盐治疗性功能障碍的发生率、相关因素及处理的信息匮乏，并强调了在该领域开展精心设计研究的必要性。
