title: Adverse effect of paroxetine on sperm.
abstract: OBJECTIVE
  To assess the effects of a selective serotonin reuptake inhibitor on semen parameters.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Thirty-five healthy male volunteers, 18-65 years old.
  
  
  METHODS
  Paroxetine administration for 5 weeks.
  
  
  METHODS
  Serum hormone levels, semen analyses, percent sperm DNA fragmentation, and questionnaire assessment of sexual function assessed before, during, and 1 month after drug administration.
  
  
  RESULTS
  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>or=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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: James Buchanan Brady Foundation, Department of Urology, Cornell Reproductive Medicine Institute, Weill Medical College of Cornell University, New York, New York 10021, USA.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Tanrikut
authors.forename: Adam S
authors.initials: AS
authors.lastname: Feldman
authors.forename: Margaret
authors.initials: M
authors.lastname: Altemus
authors.forename: Darius A
authors.initials: DA
authors.lastname: Paduch
authors.forename: Peter N
authors.initials: PN
authors.lastname: Schlegel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000009:adverse effects; D048430:Cell Shape / Q000187:drug effects; D053938:DNA Fragmentation / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000008:administration & dosage / Q000009:adverse effects*; D055101:Semen Analysis; D013094:Spermatozoa / Q000166:cytology / Q000187:drug effects* / Q000502:physiology; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine