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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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