Sexual functions and prolactin levels in patients with bipolar disorder (tur)

Abstract

Objective: Mood stabilizers and antipsychotic drugs are known to have adverse effects on sexual function. However, patients often refrain from speaking about sexual complaints that may cause dose reduction and discontinuation of the drug without medical supervision. In this study we aimed to evaluate sexual functions of patients with bipolar disorder in remission period, considering prolactin levels and medications. Method: We recruited 52 patients with bipolar disorder in remission according to DSM-IV diagnostic criteria. Prolactin levels were measured in all patients. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used to assess sexual dysfunction. Results: Mean prolactin levels were 24.71 ± 4.25 and 19.96 ± 5.52 ng/ml respectively for females and males. Patients taking mood stabilizer (MS) and mood stabilizer plus antipsychotic (AP) treatment had different prolactin levels (p<0.001). Total GRISS scores were not different for MS and MS+AP treatment groups. We didn't find a correlation between Total GRISS scores and prolactin levels. There was a significant deterioration in female non-sensuality, female dissatisfaction and anorgasmia subscales of female patients and significant deterioration in premature ejaculation, impotence and male dissatisfaction subscales of male patients. Discussion: In our sample, both men and women patients with bipolar disorder in remission have sexual dysfunctions. Our results suggest that prolactin levels are not sufficient to demonstrate the sexual dysfunction. To enhance patient compliance it is necessary to focus more on sexual symptoms of patients receiving MS and AP treatment. ÖZETAmaç: Duygudurum dengeleyici ve antipsikotik ilaçlarýn cinsel iþlevlerle ilgili yan etkileri olduðu bilinmektedir. Bununla birlikte hastalar genellikle bu yakýnmalarý hakkýnda konuþmaktan kaçýnýrlar ve cinsel iþlev bozukluklarý, hastalarýn kendi kendilerine doz azaltmalarýna ya da tedaviyi býrakmalarýna sebep olabilir. Bu çalýþmada, remisyon dönemindeki bipolar bozukluk hastalarýnýn ilaç tedavileri ve prolaktin düzeylerini dikkate alarak cinsel iþlevlerini deðerlendirmeyi amaçladýk. Yöntem: Çalýþmaya DSM-IV kriterlerine göre bipolar bozukluk tanýsý alan 52 hasta dâhil edildi. Hastalarýn prolaktin düzeyleri ölçüldü. Cinsel disfonksiyonu deðerlendirmek için, Golombok Rust Cinsel Doyum Ölçeði (GRCDÖ) kullanýldý. Bulgular: Prolaktin düzeyleri ortalamasý kadýn ve erkekler için sýrasýyla 24.71 ± 4.25 ve 19.96 ± 5.52 ng/ml idi. Duygudurum dengeleyici (DD) ve duygudurum dengeleyiciye ek antipsikotik (AP) alanlar arasýnda prolaktin seviyeleri farklýydý (p<0.001). Toplam GRCDÖ puanlarý DD ve DD+AP tedavi grubunda farklý deðildi. Toplam GRCDÖ ile prolaktin seviyeleri arasýnda korelasyon yoktu. Kadýnlarda dokunma, doyum, anorgazmi, erkeklerde prematür ejakülasyon, empotans ve doyum alt ölçeklerinde bozulma mevcuttu. Sonuç: Çalýþmamýzda, remisyondaki kadýn ve erkek bipolar bozukluk hastalarýnda cinsel disfonksiyonlar mevcuttu. Prolaktin seviyeleri cinsel disfonksiyonu yansýtmakta yeterli bulunmadý. ...