title: Treatment with citalopram, but not with agomelatine, adversely affects sperm parameters: a case report and translational review.
abstract: BACKGROUND
  Adverse effects of antidepressant drug treatmenton sexual function are well documented but the effects of antidepressants on sperm production have not been researched extensively.
  
  
  METHODS
  A narrative of an interventional case report of sperm parameters in a 30-year-old Caucasian man with a diagnosis of mixed depressive and anxiety disorder, who underwent citalopram treatment, followed by agomelatine treatment. Clinical observations prompted a review of the pre-clinical and clinical literature on the effects of antidepressant administration or treatment on sperm production and parameters. Findings from the review are discussed to suggest potential underlying mechanisms.
  
  
  RESULTS
  Abnormal sperm parameters were associated with treatment with the SSRI citalopram. There was an improvement in sperm concentration, motility, progressive motility and sperm morphology following its withdrawal. There was no similar association during subsequent treatment with agomelatine. The clinical observations reflect findings from animal studies, which indicate that antidepressants can have untoward effects on spermatogenesis.
  
  
  CONCLUSIONS
  SSRI treatment can be associated with impaired semen quality. Potential underlying mechanisms include changes in sperm DNA integrity, activation of IDO and shifting tryptophan metabolism. Further studies of the effects of antidepressants on spermatogenesis might benefit from including investigation of changes in IDO activity during antidepressant administration.
authors.affiliation: 1 Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Hesham Y
authors.initials: HY
authors.lastname: Elnazer
authors.affiliation: 1 Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: David S
authors.initials: DS
authors.lastname: Baldwin
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy; D015283:Citalopram / Q000009:adverse effects* / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy; D006801:Humans; D008297:Male; D055101:Semen Analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D013094:Spermatozoa / Q000187:drug effects*; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors; C084711:agomelatine; D009281:Naphthalenes