Sexual Dysfunction and Mood Stabilizers in Long-Term Stable Patients With Bipolar Disorder

Fecha de publicación: 01/05/2020 Fecha Ahead of Print: 02/03/2020

Autores de IIS La Fe

Ana Cristina García Blanco

Autor
María Del Carmen Carda Batalla

Autor
Lorenzo Livianos Aldana

Autor
Pilar Sierra San Miguel

Autor

Participantes ajenos a IIS La Fe

García-Portilla MP
de la Puente-Tomas, L
Sánchez-Autet M
Arranz B
Safont G
Argues, S

Grupos

Investigación en Salud Mental

Leader

Ana Cristina García Blanco

Abstract

Background: In addition to factors intrinsic to bipolar disorder (BD), sexual functioning (SF) can be affected by extrinsic causes, such as psychotropic drugs. However, the effect of mood stabilizers on SF and quality of life (QoL) is an underexplored research area. Aim: To analyze SF in BD outpatients in euthymia for at least 6 months treated only with mood stabilizers and the association between SF and QoL. Methods: A multicenter cross-sectional study was conducted in 114 BD outpatients treated with (i) lithium alone (L group); (ii) anticonvulsants alone (valproate or lamotrigine; A group); (iii) lithium plus anticonvulsants (L+A group); or (iv) lithium plus benzodiazepines (L+B group). The Changes in Sexual Functioning Questionnaire Short Form (CSFQ-14) was used. Statistical analyses were performed to compare CSFQ-14 scores among the pharmacological groups. An adaptive lasso was used to identify potential confounding variables, and linear regression models were used to study the association of the CSFQ-14 with QoL. Main Outcome Measures: Self-reports on phases of the sexual response cycle (ie, desire, arousal, and orgasm) and QoL were assessed. Results: The A group had better total SF scores than the L group and the L+B group. Relative to the A group, the L and L+B groups had worse sexual desire; the L group had worse sexual arousal; and the L+A group and the L+B group had worse sexual orgasm. Regarding sociodemographic factors, being female and older age were associated with worse total SF and all subscale scores. Among all subscales scores, higher sexual arousal scores were associated with better QoL. Clinical Implications: Potential modified extrinsic factors such as psychotropic medication that can affect SF can be addressed and adjusted to lessen side effects on SF. Strengths & Limitations: Sample of patients with euthymic BD in treatment with mood stabilizers and no antipsychotics or antidepressants, substance use as an exclusion criterion, and use of a validated, gender-specific scale to evaluate SF. Major limitations were cross-sectional design, sample size, and lack of information about stability of relationship with partner. Conclusions: Lithium in monotherapy or in combination with benzodiazepines is related to worse total SF and worse sexual desire than anticonvulsants in monotherapy. While the addition of benzodiazepines or anticonvulsants to lithium negatively affects sexual orgasm, sexual arousal (which plays a significant role in QoL) improves when benzodiazepines are added to lithium. Anticonvulsants in monotherapy have the least negative effects on SF in patients with BD. Copyright (C) 2020, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:: 1743-6095, 1743-6109
Tipo:: Review
Páginas:: 930-940
DOI:: 10.1016/j.jsxm.2020.01.032
Factor de Impacto:: 0,925 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

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Métricas

Filiaciones

García-Blanco A:: Instituto de Investigación. La Fe Hlth Res Inst, Valencia, Spain
García-Portilla MP:: Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain

Univ Oviedo, Dept Psychiat, Oviedo, Spain
de la Puente-Tomas, L:: Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain

Univ Oviedo, Dept Psychiat, Oviedo, Spain
Batalla M:: La Fe Univ & Polytech Hosp, Valencia, Spain
Sánchez-Autet M:: Parc Sanitari St Joan Deu, Barcelona, Spain
Arranz B:: Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain

Parc Sanitari St Joan Deu, Barcelona, Spain
Safont G:: Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain

Univ Barcelona, Univ Hosp Mutua Terrassa, Dept Psychiat, Barcelona, Spain
Argues, S:: Arnau Hosp, Valencia, Spain
Livianos L:: La Fe Univ & Polytech Hosp, Valencia, Spain

Univ Valencia, Dept Med, Valencia, Spain

CIBERESP 17, Valencia, Spain
Sierra P:: La Fe Univ & Polytech Hosp, Valencia, Spain

Univ Valencia, Dept Med, Valencia, Spain

Keywords

Bipolar Disorder; Sexual functioning; Lithium; Mood Stabilizers; Quality of Life

Proyectos asociados

EFECTOS DE LA MONOTERAPIA CON LITIO EN EL FUNCIONAMIENTO NEUROPSICOLOGICO DE LOS PACIENTES CON TRASTORNO BIPOLAR

Investigador Principal: LORENZO LIVIANOS ALDANA

SM I 22/2011 . 2012

CON-CIENCIA-YV: PILDORAS DE SALUD

FCT-13-7457_FECYT_2013 . MINISTERIO DE ECONOMIA Y COMPETITIVIDAD; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2013