Q:  Lithium & Sexual Function

I have been on lithium for 10 years, and have recently experienced difficulty achieving an erection during sex with my wife on two different occasions. Once was in the middle of the night, and once was in the morning after having had sex the previous night (during which I was barely able to achieve an erection). Is this a possible side efect of the medication? I do not feel any lost desire for my wife, and when I was on prozac 11 years ago, I did notice sexual side effects. I look forward to your feedback. Thank you!


Dear Ed -- 
A quick literature review reveals that the answer to your question is not the one I would have given you based on my experience, so I'm surprised and have learned something here.  I've never had a patient complain about lithium and sexual activity, but that's different than asking directly about it.  As you can see in this article, there is a fairly small rate of the kinds of problems you describe, but you'll also see why I perhaps have not been hearing about it, namely that patients don't feel that overall lithium is a major problem in this respect.  

Dr. Phelps