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Paxil, Other SSRIs Can Damage Sperm

Nov 11, 2008 | Parker Waichman LLP Paxil may contribute to male infertility, according to a study presented at the 64th annual meeting of the American Society for Reproductive Medicine in San Francisco.  According to researchers, treatment with Paxil increases DNA fragmentation in sperm, which can lead to male fertility problems.

Paxil is part of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs).  According to the co-investigator Dr. Cigdem Tanrikut, from Harvard Medical School in Boston, the research was "the first study to assess the impact of an SSRI on semen parameters in healthy men."  The study involved 35 men who took Paxil for 5 weeks. According to Reuters Health, 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.

Sperm was tested at the beginning of the study, and again after 4 weeks of Paxil treatment.  The average DNA fragmentation score increased from 13.8 percent before Paxil was begun to 30.3 percent at week 4, a statistically significant amount. The percentage of men who had a fragmentation score of 30 percent or higher before treatment rose from 10 percent to 50 percent.

Another investigator who worked on the study, Dr. Peter N. Schlegel, of Weill Medical College of Cornell University in New York, told Reuters Health that the damaged sperm was the result of  a slowing down of their transport through the body.  "Slowing down sperm transport can allow sperm to be damaged (by higher temperatures, or just 'getting too old' — being ejaculated after they should have been)," Schlegel said.

DNA fragmentation can have a detrimental affect on fertility, Tanrikut told Reuters Health. It increases the risk of failure of intrauterine insemination, and can even adversely impact pregnancy outcomes of the most advanced assisted reproductive technologies, such as in vitro fertilization, she said.

Schlegel recommended that, among men taking Paxil or another SSRI, "a special test for DNA fragmentation...should be considered."

In addition to damaging sperm, the study also found that Paxil was also associated with significant sexual dysfunction, with one third of men reporting problems with erectile function and nearly half reporting ejaculatory difficulties.

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