Healthy Skepticism Library item: 6366

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Publication type: news

Sample I.
Antidepressants may make men infertile
Guardian Unlimited 2006 Oct 24
http://www.guardian.co.uk/science/story/0,,1930255,00.html

Full text:

Antidepressants may make men infertile

Ian Sample
Tuesday October 24, 2006
Guardian Unlimited

Bestselling antidepressant drugs may be making some men infertile, research reported yesterday suggested.

The warning follows a study of two men at Cornell Medical Centre in New York whose sperm counts dropped to almost zero while taking the drugs but recovered to healthy levels whenever their medication was suspended.

The men were tested over a two-year period while being treated with the selective serotonin reuptake inhibitors (SSRIs) Citalopram (Cipramil) or Sertraline (Lustral), which belong to the same class of drugs as Prozac and Seroxat, Britain’s biggest selling antidepressants.

A further 12 men at the clinic were later found to have experienced a similar but less dramatic fall in sperm counts while on the medication.

Doctors yesterday urged men receiving the drugs not to stop taking them before consulting their GPs. While only two men at the clinic had a dramatic reaction to the drugs, the researchers believe large numbers of men may be affected to a lesser extent.

The team, lead by Professor Peter Schlegel, has launched an urgent clinical trial of 30 healthy men with the aim of confirming how common the possible side effect might be.

“These were men with normal sperm counts that went to nearly zero when they were on these antidepressants but returned to normal when they were off them,” Prof Schlegel said.

“It’s a dramatic effect and it has never been described before. We believe that while it has had a profound effect on these two men, it could be having a significant but more subtle effect on many more.”

The previously unknown effect could be having a significant effect on couples trying to start families, Prof Schlegel said.

Demand for antidepressants has soared in recent years, with doctors writing 19m prescriptions for Seroxat alone in 2004.

SSRI antidepressants are already known to delay, and even prevent, ejaculation in some men. But never before have the drugs been found to interfere with the movement of sperm.

Doctors yesterday urged men receiving the drugs not to stop taking them before consulting their GPs. While only two men at the clinic had a dramatic reaction to the drugs, the researchers believe large numbers of men may be affected to a lesser extent.

The team, lead by Professor Peter Schlegel, has launched an urgent clinical trial of 30 healthy men with the aim of confirming how common the possible side effect might be.

“We know these drugs act on nerve endings, and it looks as though they are acting on the nerves in the vas deferens, the tube that should transport sperm to the prostate just before ejaculation,” said Prof Schlegel, who presented his research at the American Society for Reproductive Medicine conference in New Orleans yesterday.

“These individuals still ejaculate normally, but the sperm are not being transported. There are almost no sperm coming out.”

Experts in the field praised the research for uncovering what might prove to be a significant side effect for many men taking the drugs.

“There are only two patients, so you have to be careful, but this is very interesting work,” said Allan Pacey, senior lecturer in andrology at Sheffield University.

“It’s a well designed study, with sequential measurements of sperm count and quality in the same people. These were measured while the men were on the drug and off the drug, and there seems to be a major correlation. This is something we should go out and look at in a lot more detail. Maybe this is an unknown side effect of this drug that is only just coming to light.”

The study follows previous research that found women taking SSRIs were almost twice as likely to have a low birth weight baby and twice as likely to have a stillbirth as the others. The babies of women on SSRIs were also more likely to suffer from seizures.