Adverse effect of paroxetine on sperm
Adverse effect of paroxetine on sperm
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DOI：
10.1016/j.fertnstert.2009.04.039
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发表时间：
2010-08-01
影响因子：
6.7
通讯作者：
Schlegel, Peter N.
中科院分区：
文献类型：
--
作者：
Tanrikut, Cigdem;Feldman, Adam S.;Schlegel, Peter N.
目的：评估选择性血清素再摄取抑制剂对精液参数的影响。设计：前瞻性研究。地点：学术医疗中心。患者：35 名健康男性志愿者，18-65 岁。干预措施：帕罗西汀给药 5 周。主要结果指标：血清激素水平、精液分析、精子 DNA 碎片百分比以及之前评估的性功能问卷评估，给药期间和给药后 1 个月。结果：与基线 (13.8%) 相比，服用帕罗西汀 (30.3%) 的男性平均精子 DNA 碎片显着更高。在帕罗西汀治疗前，9.7% 的患者末端脱氧核苷酸转移酶 dUTP 缺口末端标记 (TUNEL) 评分≥ 30%，而治疗第 4 周时这一比例为 50%。服用帕罗西汀时出现异常 DNA 片段的比值比 (OR) 为 9.33（95% 置信区间，2.3-37.9）。校正年龄和体重指数的多变量逻辑回归证实了这种相关性（OR，11.12）。高达 35% 的男性注意到勃起功能发生显着变化，高达 47% 的男性报告在药物治疗后出现射精困难。停止治疗后注意到性功能恢复到接近正常。帕罗西汀治疗期间标准精液参数没有显着改变。结论：在精液参数正常的男性中，帕罗西汀在相当大比例的受试者中诱导异常精子 DNA 片段化，但对精液参数没有可测量的影响。大量服用帕罗西汀的男性的生育潜力可能会受到精子 DNA 完整性的这些变化的不利影响。 （Fertil Steril (R) 2010；94: 1021-6。(C) 2010，美国生殖医学会。）
Objective: To assess the effects of a selective serotonin reuptake inhibitor on semen parameters.Design: Prospective study.Setting: Academic medical center.Patient(s): Thirty-five healthy male volunteers, 18-65 years old.Intervention(s): Paroxetine administration for 5 weeks.Main Outcome Measure(s): Serum hormone levels, semen analyses, percent sperm DNA fragmentation, and questionnaire assessment of sexual function assessed before, during, and 1 month after drug administration.Result(s): Mean sperm DNA fragmentation was significantly higher for men while on paroxetine (30.3%) versus baseline (13.8%). Before paroxetine, 9.7% of patients had a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) score >= 30% compared with 50% at week 4 of treatment. The odds ratio (OR) of having abnormal DNA fragmentation while taking paroxetine was 9.33 (95% confidence interval, 2.3-37.9). Multivariate logistic regression correcting for age and body mass index confirmed this correlation (OR, 11.12). Up to 35% of men noted significant changes in erectile function and up to 47% of men reported ejaculatory difficulties on medication. Recovery to near-normal sexual function was noted after stopping treatment. Standard semen parameters were not significantly altered during paroxetine treatment.Conclusion(s): In men with normal semen parameters, paroxetine induced abnormal sperm DNA fragmentation in a significant proportion of subjects, without a measurable effect on semen parameters. The fertility potential of a substantial number of men on paroxetine may be adversely affected by these changes in sperm DNA integrity. (Fertil Steril (R) 2010; 94: 1021-6. (C) 2010 by American Society for Reproductive Medicine.)