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Treatment with citalopram, but not with agomelatine, adversely affects sperm parameters: a case report and translational review

Published online by Cambridge University Press:  20 November 2013

Hesham Y. Elnazer  and
David S. Baldwin
Hesham Y. Elnazer*
Affiliation:
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK Assertive Outreach Team and Rehabilitation Psychiatry, Sussex Partnership Foundation NHS Trust, Chichester, UK
David S. Baldwin
Affiliation:
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
*
Hesham Y. Elnazer, University Department of Psychiatry, Academic Centre College Keep, 4-12 Terminus Terrace, Southampton, SO14 3DT, UK. Tel: +44 2380 718 520; Fax: +44 2380 718 532; E-mail: [email protected]
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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.

Keywords

agomelatinecitaloprammale infertilityspermatogenesis
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 26 , Issue 2 , April 2014 , pp. 125 - 129
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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References

1.Baldwin, DS, Foong, T. Antidepressant drugs and sexual dysfunction. Br J Psychiatry 2013;202:396–397.Google Scholar
2.Bataineh, HN, Daradka, T. Effects of long-term use of fluoxetine on fertility parameters in adult male rats. Neuro Endocrinol Lett 2007;28:321–325.Google Scholar
3.Alzahrani, HA. Sister chromatid exchanges and sperm abnormalities produced by antidepressant drug fluoxetine in mouse treated in vivo. Eur Rev Med Pharmacol Sci 2012;16:2154–2161.Google ScholarPubMed
4Vieira, ML, Hamada, RY, Gonzaga, NIet al. Could maternal exposure to the antidepressants fluoxetine and St. John's Wort induce long-term reproductive effects on male rats. Reprod Toxicol 2013;35:102–107.CrossRefGoogle Scholar
5.Stein, DM, Schnieden, H. Effect of antidepressant drugs on the in-vitro egg-penetrating ability of golden hamster epididymal spermatozoa. J Reprod Fertil 1983;68:227–233.Google Scholar
6.Shishkina, GT, Dygalo, NN. Role of the serotoninergic system in the acceleration of sexual maturation in wild Norway rats selected for reduced aggressiveness toward humans. Comp Biochem Physiol C Toxicol Pharmacol 2000;125:45–51.Google Scholar
7.George, S, Chuttani, K, Basu, SK. Radiation protection of male fertility in mouse and rat by a combination of 5-hydroxy-l-tryptophan and a thiol compound (AET). Acta Oncol 1992;31:669–672.Google Scholar
8.Tanrikut, C, Schlegel, PN. Antidepressant-associated changes in semen parameters. Urology 2007;69:185.e5–185.e7.Google Scholar
9.Relwani, R, Berger, D, Santoro, Net al. Semen parameters are unrelated to BMI but vary with SSRI use and prior urological surgery. Reprod Sci 2011;18:391–397.Google Scholar
10.Koyuncu, H, Serefoglu, EC, Yencilek, E, Atalay, H, Akbas, NB, Sarıca, K. Escitalopram treatment for premature ejaculation has a negative effect on semen parameters. Int J Impot Res 2011;23:257–261.Google Scholar
11.Safarinejad, MR. Sperm DNA damage and semen quality impairment after treatment with selective serotonin reuptake inhibitors detected using semen analysis and sperm chromatin structure assay. J Urol 2008;180:2124–2128.Google Scholar
12.Tanrikut, C, Feldman, AS, Altemus, M, Paduch, DA, Schlegel, PN. Adverse effect of paroxetine on sperm. Fertil Steril 2010;94:1021–1026.Google Scholar
13.Maier, U, Koinig, G. Andrological findings in young patients under long-term antidepressive therapy with clomipramine. Psychopharmacology 1994;116:357–359.Google Scholar
14.Naranjo, CA, Busto, U, Sellers, EMet al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239–245.CrossRefGoogle ScholarPubMed
15.Hill, AB. The environment and disease: association or causation? Proc R Soc Med 1965;58:295–300.Google ScholarPubMed
16.Kantartzi, PD, Goulis, ChD, Goulis, GD, Papadimas, I. Male infertility and varicocele: myths and reality. Hippokratia 2007;11:99–104.Google Scholar
17.Yamamoto, M, Hibi, H, Hirata, Yet al. Effect of varicocelectomy on sperm parameters and pregnancy rate in patients with subclinical varicocele: a randomized prospective controlled study. J Urol 1996;155:1636–1638.Google Scholar
18.Unal, D, Yeni, E, Verit, A, Karatas, OF. Clomiphene citrate versus varicocelectomy in treatment of subclinical varicocele: a prospective randomized study. Int J Urol 2001;8:227–230.Google ScholarPubMed
19.Jrad-Lamine, A, Henry-Berger, J, Gourbeyre, Pet al. Deficient tryptophan catabolism along the kynurenine pathway reveals that the epididymis is in a unique tolerogenic state. J Biol Chem 2011;286:8030–8042.Google Scholar
20.Fuchs, D, Forsman, A, Hagberg, Let al. Immune activation and decreased tryptophan in patients with HIV-1 infection. J Interferon Res 1990;10:599–603.Google Scholar
21.Alberati-Giani, D, Cesura, AM. Expression of the kynurenine enzymes in macrophages and microglial cells: regulation by immune modulators. Amino Acids 1998;14:251–255.Google Scholar
22.Oxenkrug, GF. Metabolic syndrome, age-associated neuroendocrine disorders, and dysregulation of tryptophan–kynurenine metabolism. Ann N Y Acad Sci 2010;1199:1–14.Google Scholar