Sexual dysfunction, lithium

Despite occasional reports of reduced libido and erectile dysfunction, lithium causes little in the way of sexual dysfunction in men or women (425). In a brief review of the sexual adverse effects of psychotropic drugs, reduced libido and arousal with lithium were mentioned in passing, particularly when it was combined with other drugs (which, of course, makes it difficult to implicate lithium) (426). 

A 49-year-old man with bipolar disorder had erectile dysfunction shortly after starting to take haloperidol 50 mg/day and lithium 1500 mg/day (36). Before this he had had normal sexual function. After 2 months, the dosage of haloperidol was reduced to 20 mg/day, but the sexual dysfunction persisted and did not... 

Atypical antipsychotics such as aripiprazole, olanzapine, que-tiapine, risperidone, and ziprasidone are effective as monotherapy or adjunctive therapy with lithium and valproate in the treatment of acute mania. Some antipsychotics have the potential to cause adverse effects such as extrapyramidal reactions, sedation, depression, emotional blunting, sexual dysfunction, weight gain, and orthostatic hypotension. Prophylactic use of antipsychotics may be needed for some patients with recurrent mania or mixed states, but the risks versus benefits must be weighed because of long-term adverse effects (e.g., obesity, type 2 diabetes, hyperlipidemia, hyperprolactinemia, cardiac disease, and tardive dyskinesia). ... 

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