ASRM 64th Annual Meeting

Treatment with paroxetine was associated with increased DNA fragmentation in sperm, according to study results presented at the American Society for Reproductive Medicine 64th Annual Meeting in San Francisco.

"In volunteer male patients with normal semen parameters, paroxetine induced abnormal sperm DNA fragmentation in a significant proportion of patients. ... The fertility potential of a substantial proportion of men on paroxetine may be adversely affected by these changes in sperm DNA integrity," wrote the researchers from Massachusetts General Hospital and Weill Medical College of Cornell University.

They enrolled 35 healthy men aged 18 to 65 years in the prospective clinical trial. Volunteers were assigned daily paroxetine for five weeks in varying doses: week one, 10 mg; week two, 20 mg; weeks three and four, 30 mg; and week five, 20 mg. The researchers analyzed semen at baseline, weeks two and four and one month after treatment with paroxetine was stopped.

Treatment with paroxetine increased the mean DNA fragmentation score from 13.8% at baseline to 30.3% (P=.0002). Before starting treatment with paroxetine, 9.7% of men had a fragmentation score ≥30% compared with 50% of men at week four (P=.001).

The drug was associated with an OR of 9.33 (95% CI, 2.3-37.9) for abnormal DNA fragmentation, which persisted after adjustment for age and BMI (P=.0003).

Up to 35% of men reported significant changes in erectile function and up to 47% reported ejaculatory problems while receiving paroxetine, according to volunteer responses from the Brief Sexual Function Inventory. However, partial recovery of sexual function was observed one month after cessation of paroxetine.