Adverse effect of paroxetine on sperm.
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.
Tanrikut
Cigdem
C
James Buchanan Brady Foundation, Department of Urology, Cornell Reproductive Medicine Institute, Weill Medical College of Cornell University, New York, New York 10021, USA.
Feldman
Adam S
AS
Altemus
Margaret
M
Paduch
Darius A
DA
Schlegel
Peter N
PN
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
D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine