Adverse effect of paroxetine on sperm

• Published in: Fertility and sterility Vol. 94; no. 3; pp. 1021 - 1026
• Main Authors: Tanrikut, Cigdem, Feldman, Adam S., Altemus, Margaret, Paduch, Darius A., Schlegel, Peter N.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2010; Elsevier
• Subjects: Adolescent; Adult; Aged; antidepressants; Antidepressive Agents, Second-Generation - administration & dosage; Antidepressive Agents, Second-Generation - adverse effects; Biological and medical sciences; Birth control; body mass index; Cell Shape - drug effects; DNA fragmentation; DNA Fragmentation - drug effects; Dose-Response Relationship, Drug; ejaculation; erectile dysfunction; Gynecology. Andrology. Obstetrics; Humans; Internal Medicine; Male; Male infertility; Medical sciences; Middle Aged; Neuropharmacology; Obstetrics and Gynecology; Paroxetine - administration & dosage; Paroxetine - adverse effects; Pharmacology. Drug treatments; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Semen Analysis; sperm; Spermatozoa - cytology; Spermatozoa - drug effects; Spermatozoa - physiology; Sterility. Assisted procreation; Young Adult; ejaculation; semen analysis; Male infertility; body mass index; DNA fragmentation; antidepressants; sperm; erectile dysfunction; Psychotropic; Toxicity; Reuptake inhibitor; Selective serotonin reuptake inhibitor; Fragmentation; Body mass index; Ejaculation; Piperidine derivatives; Antidepressant agent; Male genital diseases; Paroxetine; Serotonin; Erection disorders; Semen; Gynecology; Obstetrics; DNA; Neurotransmitter; Male sterility
• ISSN: 0015-0282; 1556-5653; 1556-5653
• DOI: 10.1016/j.fertnstert.2009.04.039

To assess the effects of a selective serotonin reuptake inhibitor on semen parameters. Prospective study. Academic medical center. Thirty-five healthy male volunteers, 18–65 years old. Paroxetine administration for 5 weeks. Serum hormone levels, semen analyses, percent sperm DNA fragmentation, and questionnaire assessment of sexual function assessed before, during, and 1 month after drug administration. Mean sperm DNA fragmentation was significantly higher for men while on paroxetine (30.3%) versus baseline (13.8%). Before paroxetine, 9.7% of patients had a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) score ≥30% compared with 50% at week 4 of treatment. The odds ratio (OR) of having abnormal DNA fragmentation while taking paroxetine was 9.33 (95% confidence interval, 2.3–37.9]. Multivariate logistic regression correcting for age and body mass index confirmed this correlation (OR, 11.12). Up to 35% of men noted significant changes in erectile function and up to 47% of men reported ejaculatory difficulties on medication. Recovery to near-normal sexual function was noted after stopping treatment. Standard semen parameters were not significantly altered during paroxetine treatment. In men with normal semen parameters, paroxetine induced abnormal sperm DNA fragmentation in a significant proportion of subjects, without a measurable effect on semen parameters. The fertility potential of a substantial number of men on paroxetine may be adversely affected by these changes in sperm DNA integrity.