Escitalopram treatment for premature ejaculation has a negative effect on semen parameters

Abstract

The aim of this study was to determine the impact of long-term escitalopram treatment on semen parameters of patients with lifelong premature ejaculation (PE). Between November 2008 and January 2010, patients admitted to urology outpatient clinic with a self-reported complaint of PE were evaluated. Medical and sexual history of patients were recorded and patients with lifelong PE (a total of 25 patients) who met the International Society of Sexual Medicine definition were asked to record their intravaginal ejaculatory latency time (IELT) for 1 month, complete Premature Ejaculation Diagnostic Tool (PEDT) questionnaire and give semen samples. Afterwards, patients received 10 mg escitalopram daily for 12 weeks and were invited for control visits at first and third month of treatment. During control visits, PEDT was administered again whereas IELTs were recorded and semen samples were re-examined. PEDT scores, arithmetic means of IELTs and results of semen analyses, which were recorded at baseline, first and third month were compared. At the third month of treatment, a significant increase in mean IELTs and a significant decrease in PEDT scores were detected. However there was a significant decrease in sperm concentration, motility and morphology when compared with the baseline semen measures. Daily escitalopram treatment effects the semen parameters of patients with lifelong PE. Further investigations with larger series are needed to see whether other serotonin reuptake inhibitors have similar side effects and to expose the exact mechanism underlying it. Different treatment modalities should be suggested to patients who desire fertility.

Deleterious effects of selective serotonin reuptake inhibitor treatment on semen parameters in patients with lifelong premature ejaculation

“…35 The single study, which demonstrates the impact of chronic SSRI treatment on semen parameters of lifelong PE patients, revealed semen parameters, which were initially normal. 13 At the end of the 12-week escitalopram treatment, a significant decrease in sperm concentration, motility and normal sperm morphology was demonstrated. This prospective study revealed that prolonged SSRI treatment induced further deterioration in all the major semen parameters (concentration, motility, morphology).…”

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

“…Administration of escitalopram (daily dosage 10 mg) to patients with lifelong premature ejaculation for 12 weeks has been associated with a significant decrease in sperm concentration, motility and morphology, when compared with baseline semen measures (10). Further investigations suggest that SSRIs can impair semen quality and damage sperm DNA integrity in depressed fertile men (11).…”

“…Preclinical investigations in experimental animals indicate that a range of antidepressants can have untoward effects on spermatogenesis and sperm viability (2-7). Observations from a limited number of case series and case reports together suggest that antidepressant drug treatment can be associated with abnormal spermatogenesis and male infertility (8)(9)(10)(11)(12)(13). We report the case of a 30-year-old man who was found to have abnormal sperm parameters during treatment with the selective serotonin reuptake inhibitor (SSRI) citalopram, which resolved once citalopram was withdrawn: subsequent treatment with the novel antidepressant agomelatine (a melatonin agonist and 5-HT2C receptor antagonist) was not found to be associated with abnormal sperm parameters.…”

Current pharmacological agents for the treatment of premature ejaculation

“…Akılda tutulması gereken bir konu olarak çocuk isteyen çiftler için SSRI'ların uzun süreli kullanımlarında sperm motilitesine, sperm DNA sına zarar verebileceğidir. Bu duruma sebep olan mekanizmalar tam olarak aydın-latılamamış olmasına rağmen fertilite üzerine negatif etkisi çalışmalarla ortaya konulmuştur [15][16][17].…”