Wednesday, November 12, 2008

Antidepressant Drugs May Damage Sperm, Hurt Male Fertility

Today, Reuters is reporting on new research being done on male treatment with paroxetine (Paxil), which belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressant drugs. It has been found that Paxil increases DNA fragmentation in sperm. This new research is being presented at the American Society for Reproductive Medicine 64th annual meeting in San Francisco.

The five-fold increase in the number of men who developed abnormal sperm DNA while being treated with paroxetine is "troubling" and "suggests an adverse effect on fertility," according to co-investigator Dr. Cigdem Tanrikut, from Harvard Medical School in Boston, who was interviewed by a reporter from Reuters.

This clinical trial is considered by researchers to be the first study to assess the impact of an SSRI on semen parameters in healthy men, and consisted of a relatively small group of 35 men who took paroxetine for 5 weeks. The drug was administered in once-daily doses of 10 mg the first week, 20 mg in the second week, 30 mg the third and fourth week, and 20 mg in the fifth week. At the conclusion, tests were conducted on semen and comparisons were made with the semen analysis done before the Paxil regmen.

Tests were conducted on semen samples obtained prior to starting paroxetine and after 4 weeks of treatment. The average DNA fragmentation score increased from 13.8 percent before paroxetine was begun to 30.3 percent at week 4, a statistically significant amount. Sperm damage in the men rose 10% to 50% higher than their pre-treatment figures.

Paxil was associated with significant sexual dysfunction as well; one third of men reported problems with erectile function and nearly half reported ejaculatory difficulties (although their sperm looked normal in all aspects during the tests).

"DNA integrity is crucial to normal fertility," Tanrikut said.

At the 2008 American Psychiatric Association meeting in Washington DC, which I attended, I noted that many MD's are getting fed up with side effects stemming from pharmaceutical antidepressants. Still, they remain some of the most often prescribed drugs in the United States. Herbal products are gaining momentum in this important health category as well.


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