official website and that any information you provide is encrypted Fertility in persons with epilepsy: 1935-1974. 2017;1034:63-101. doi: 10.1007/978-3-319-69535-8_8. This post will focus on the antipsychotic drugs, which are now used to treat many psychiatric disorders other than schizophrenia, including insomnia, anxiety disorders, major depression and bipolar disorder. One month after discontinuing his carbamazepine and starting phenytoin monotherapy, his semen parameters were found to be normal and his wife became pregnant within 6 months (40, 41). Aaberg RA, Sauer MV, Sikka S, Rajfer J. Indeed, SA certainly does not evaluate many of the parameters of sperm that may impact MFI such as an intact acrosome reaction [8]. sharing sensitive information, make sure youre on a federal Dallas, TX 75390, 2023 The University of Texas Southwestern Medical Center, Internal Medicine - Rheumatology Diseases, paternal safety of anti-rheumatic medications. OECD Health Statistics. Antihypertensives Ahmad G, Moinard N, Jouanolou V, Daudin M, Gandia P, Bujan L. In vitro assessment of the adverse effects of antiretroviral drugs on the human male gamete. Kumar VS, Sharma VL, Tiwari P, Singh D, Maikuhuri JP, Gupta G, et al. The study group comprised 10 patients who experienced ED associated with the use of olanzapine. Ocek L, Tarhan H, Uluda FI, Sariteke A, Kse C, Colak A, et al. Another retrospective trial has demonstrated an association between SSRI use and decreased sperm motility (23). Herzog AG, Seibel MM, Schomer DL, Vaitukaitis JL, Geschwind N. Reproductive endocrine disorders in men with partial seizures of temporal lobe origin. Androgens and fertility. Copyright 2023 MGH Center for Women's Mental Health | All Rights Reserved | Site Developed by, Perinatal and Reproductive Psychiatry Program, A Neurosteroid Intervention for Menopausal and Perimenopausal Depression, UPWARD & UPWARD(S) Preventing Depressive Relapse in Pregnant Women, National Pregnancy Registry for Psychiatric Medications , STEPS for PPD Screening and Treatment Enhancement for Postpartum Depression in the MGB System, Suicide Prevention and Awareness Resources. NCHS data brief, no 283. As a library, NLM provides access to scientific literature. Sperm concentration and progressive motility were significantly reduced in subjects treated with antipsychotics compared to the untreated controls and to the other classes of psychotropics (p < 0.05). Which cold meds are safe during pregnancy, What noninvasive prenatal testing can (and cant) tell you about your baby, Valors story: Love, loss, and legacy with trisomy 18, How to handle pumping at work: 5 tips for breastfeeding moms, Planning for pregnancy? Res. Selective Serotonin Reuptake Inhibitors and Fertility: Considerations for Couples Trying to Conceive. 2022 Jan-Feb;16(1):15579883221075520. doi: 10.1177/15579883221075520. Spanish Working Group for the study of psychotropic-related sexual dysfunction. Clin Pharmacol Ther (2019) 105:598613. Hayashi T, Yoshida S, Yoshinaga A, Ohno R, Ishii N, Yamada T. Improvement of oligoasthenozoospermia in epileptic patients on switching anti-epilepsy medication from sodium valproate to phenytoin. Listed are medication categories and specific medications evaluated. Amann RP. As such, the data linking SSRIs to MFI are, at the present time, suggestive but not conclusive. In many cases of MFI, a definitive cause for abnormalities is never identified. Infertility, which is defined as the failure to obtain a clinical pregnancy after at least 12 months of regular unprotected sexual intercourses, can be due to male factors in about 30%50% of cases, alone or in combination with female factors (1). Nrr L, Bennedsen B, Fedder J, Larsen ER. Semen samples were centrifuged at 1,500g for 10min and an aliquot of 500 l of seminal plasma were stored at 20C until processing. 2023 Dec;61(1):89-99. doi: 10.1080/13880209.2022.2157018. Levitas E, Lunenfeld E, Weiss N, Friger M, Har-Vardi I, Koifman A, et al. In a 2003 selective cohort study, researchers from Norway investigated the effect of carbamazepine and valproate on semen quality in a treatment arm for each medication and a control group receiving no medication. Kang JS, Lee MH. Effects of alfuzosin and tamsulosin on sperm parameters in healthy men: results of a short-term, randomized, double-blind, placebo-controlled, crossover study. Thus, the final sample size included 20 patients. The spermicidal and antitrichomonas activities of SSRI antidepressants. Farombi EO, Ugwuezunmba MC, Ezenwadu TT, Oyeyemi MO, Ekor M. Tetracycline-induced reproductive toxicity in male rats: effects of vitamin C and N-acetylcysteine. Even though the WHO criteria likely serves as a fair representation for normal male characteristics, the absence of a control group increases the likely-hood of ignoring an important confounding variable in a certain trial. Moreover, 10 healthy age-matched men, who have conceived in the previous 6 months, were included in the Control Group. The aim of this observational study was to develop a new quantitative liquid chromatography-mass spectrometry (LC-MS/MS) method for Therapeutic-Drug-Monitoring (TDM) of psychotropic drugs in seminal fluid to investigate potential gonadotoxic effects in patients with reduced fertility. In fact, although several analytical TDM methods have been validated in different biological matrices (i.e., serum, plasma, urine, cells, and tissues), few drug assays have been developed for seminal fluid. TDM consist in measuring specific drugs at designated intervals to maintain a constant concentration to optimize individual dosage regimens. Lebovic, DI, Gordon, JD. The major limitations of the study are represented by the restricted sample size and the limited number of psychotropic drugs included. Federal government websites often end in .gov or .mil. virtual beauty. doi:10.1016/j.bmcl.2006.01.078, 10. In fact, only few studies on male infertility have been conducted in patients treated with psychotropic drugs, reporting seminal alterations associated with specific classes of antidepressants, benzodiazepines, and antipsychotics. Antipsychotic medications can have various side effects and complications, including: Drug-induced movement disorders. Of the 20 patients included, 6 were treated with antidepressants; 4 with benzodiazepines and 10 with antipsychotics. Pharmaco Epidemiol Drug Saf (2015) 24:120714. Processed calibration standards and QC samples were used to develop the calibration curve for the method validation. Rubin RT, Poland RE, Lesser IM. We want to do everything we can to keep you healthy while also helping you achieve your family goals. They block the movement of free calcium ions, which serve as important secondary messengers, between ion channels and ionophores. No differences were observed in volume and abnormal morphology percentage among the three study Groups and the Control Group, as well as for age (Table 3). I recently researched the paternal safety of anti-rheumatic medications, and while more data must be gathered, findings to date show that most of those drugs do not affect mens fertility or pose a risk to a partners pregnancy. Why three months? Received 2011 Oct 5; Accepted 2011 Dec 31. Data were acquired and processed with Analyst 1.5.1 software. The evidence is also determined to have evaluated the impact on fertility and change in sperm count or function. OTC medications linked to ED include antihistamines, H2 . Rabin DS, Qadeer U, Steir VE. HHS Vulnerability Disclosure, Help Marquis A, Kuehni CE, Strippoli MP, Khne T, Brazzola P. Swiss Pediatric Oncology Group. Therefore, current standard of care is to obtain a semen sample that is cryopreserved before initiation of chemotherapy for fertility preservation (57). Many psychotropics hormonal and sexual side effects are directly related to drugs mechanism of action and have been largely studied, mainly due to reduced testosterone and increased prolactin and gonadotropins levels, as well as to the presence of sexual dysfunction, concerning primarily the erection and ejaculation mechanisms. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Despite these design limitations, the literature does suggest that certain medications may, in fact, prove detrimental to male reproductive potential. Share this article via email with one or more people using the form . Application of the upgraded image superimposition system (SIAS) to the assessment of sperm kinematics. Int J Urol. Elia J, Imbrogno N, Delfino M, Mazzilli F. Retrograde ejaculation and abnormal hormonal profile in a subject under treatment with valproate and phenytoin. According to WHO (5 percentile), we considered: i) oligozoospermia: total number of spermatozoa below the lower reference limit (15 106/ml); ii) asthenozoospermia: percentage of progressively motile spermatozoa below the lower reference limit (32%); iii) teratozoospermia: percentage of morphologically abnormal spermatozoa above the reference limit (96%) (1). J Appl Toxicol (2015) 35:100716. The effect of nifedipine, a calcium channel blocker, on human spermatozoal functions. The site is secure. beauty minis. RM conceived the study, interpreted and analyzed the data, and drafted the manuscript. Calibrator samples and QC samples were treated exactly as patients specimens. Rste LS, Taubll E, Haugen TB, Bjrnenak T, Saetre ER, Gjerstad L. Alterations in semen parameters in men with epilepsy treated with valproate or carbamazepine monotherapy. Overall, sperm progressive motility was significantly reduced in patients treated with psychotropic drugs (Total Group) compared to the Control Group (36.8 11.6% vs. 46.3 10.0%, p = 0.03). Sildenafil citrate (Viagra) impairs fertilization and early embryo development in mice. Bethesda, MD 20894, Web Policies Studies on anti-epileptic medications including carbamazepine, phenytoin and valproate have suggested specific drug-dependent side effects, including abnormal sperm morphology, reduced motility, lower sperm count, and reduced testicular volume. To talk with a doctor about how medications may affect a current or future pregnancy, call 214-645-8300 or request an appointment online. MeSH Unable to load your collection due to an error, Unable to load your delegates due to an error. However, several other studies have failed to demonstrate such a correlation (17, 19, 20). In addition, adjustments which solve this problem may prevent other, more invasive work-ups or procedures. 185 Cambridge St Suite 2200 Levitas E, Lunenfeld E, Weisz N, Friger M, Har-Vardi I, Potashnik G. Relationship between sexual abstinence duration and the acrosome index in teratozoospermic semen: analysis of 1800 semen samples. Suitable for. This observational, case-control, clinical study included patients referring to the Endocrinology-Andrology Unit of SantAndrea Hospital Sapienza University of Rome. Effects of phosphodiesterase-5 inhibitors on Leydig cell secretory function in oligoasthenospermic infertile men: a randomized trial. Search Conditions & Treatments HPLC-grade acetonitrile was purchased from Carlo Erba reagents (Milan, Italy) and formic acid was from Merck (Darmstadt, Germany). Kornstein, SG, Clayton AH. More in: Mass spectrometer parameters were optimized to maximize sensitivity for all analytes (Table 1). Psychotropic drugs are largely used worldwide and frequently prescribed to patients, representing some of the most used drugs with prescription prevalence in the general population ranging from 6% to 15% (4, 5). Seminal drugs and metabolites levels were detectable in all samples. However, the pregnancy rate per transfer in embryos derived from men taking CCBs was only 17.4% (32). Thonneau P, Marchand S, Tallec A, Ferial ML, Ducot B, Lansac J, et al. doi:10.1371/journal.pone.0181115, 15. Side effects of several classes of psychotropic drugs include impaired sexual function and fertility. PMC The cycle of the seminiferous epithet-lium in humans: a need to revisit? Trazodone has been used off-label in urological patients. doi:10.1046/j.1439-0272.1999.00276.x, 16. Semen analysis was carried out according to 2010 WHO guidelines, evaluating spermatozoa morphology, motility, and concentration (1). There are potentially many different causes of male infertility, including hormonal, anatomical, and secondary to exposure to exogenous substances. Evidence also shows that SSRIs have a spermicidal effect in vitro (24). According to the class of psychotropics taken, the subjects enrolled in the case group were divided in three study groups: Group A: n. 6/20 (30.0%) subjects treated with SSRI antidepressants (Fluoxetine); Group B: n. 4/20 (20.0%) subjects treated with benzodiazepines (Alprazolam); Group C: n. 10/20 (50.0%) subjects treated with antipsychotics/antiepileptics (Quetiapine, Olanzapine, Levetiracetam, Aripiprazole). The validation was conducted considering selectivity, LLOQ, recovery, accuracy and precision, matrix effects, and stability. This review article will focus on the effects of certain pharmaceutical medications that may be associated with male infertility. Based on our preliminary results in a restricted group of treated patients, a minority of the studied medications seems to be transported in the seminal fluid in low concentrations and might be related to reduced fertility in male partners of infertile couples. 1 Altmetric Metrics A Correction to this article was published on 18 April 2022 This article has been updated Abstract Infertility is a significant cause of anxiety, depression, and social stigma among couples and families. General and andrological clinical examination, semen analysis and seminal drugs, and metabolites levels determination were performed for each subject. Attia SM, Badary OA, Hamada FM, Hrab de Angelis M, Adler ID. Accessibility 2005. Your Pregnancy Matters, Next Article Moreover, a lower impact of psychotropic drugs on male fertility might improve patients compliance to treatment in a population with a poor adherence high rate. Effects of antiretroviral therapy on semen quality. Calcium Channel Blockers (CCBs) are calcium ion antagonists. As the process of male ejaculation encompasses a complex coordination of actions, this affect of AABs is thought to be secondary to the effect on dopamine and serotonin, among other mechanisms (34). Thus, the future evaluation and grading of psychotropic drugs might represent a valid instrument for the clinical assessment and management of infertile couples. A summary of the current evidence is offered in Table 1. Arch Ital Urol Androl (2018) 9:448. Another variable that can be modified by researchers to a large extent is time. Chromatographic separation was performed using a reversed phase column (Kynetex 2.6 m C18 100 pore size, LC Column 50 x 2.00, mm, Phenomenex, CA, USA) equipped with a security guard precolumn (Phenomenex, Torrance, CA, USA) containing the same packing material. There are some medications that can cause low sperm counts or reduce sperm motility. Lu S, Zhao Y, Hu J, Li X, Zhang H, You L, et al. 1-3 Patients who develop drug-induced sexual dysfunction are more likely to be non-adherent. Of note, there was no difference in fertility in any of the men, as defined by pregnancy, compared with the controls (42). or 214-645-8300 Selective serotonin reuptake inhibitors (SSRIs), like paroxetine (Paxil), can cause sexual side effects. The https:// ensures that you are connecting to the Use of selective serotonin reuptake inhibitors reduces fertility in men. government site. doi:10.1002/cpt.1124, 22. In fact, even very small doses of an agent may cause significant side effects in certain individuals. Tanrikut C, Feldman AS, Altemus M, Paduch DA, Schlegel PN. Although antidepressants are known to be associated with sexual side-effects, their effects on semen parameters and other markers of male fertility have been less thoroughly described. Reproductive Endocrinology & Infertility. Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update. Drug Chem Toxicol (2012) 35:4505. Furthermore, self-reports from the subjects showed that 35% cited considerable changes in erectile function while 47% noted difficulties with ejaculation while taking paroxetine. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. Cognitive dysfunction in depression: Neurocircuitry and new therapeutic strategies. All of them were Caucasian. In particular, alprazolam, olanzapine, and levetiracetam showed seminal and serum similar concentrations, while fluoxetine, quetiapine, and aripiprazole were detectable, but seminal levels were significantly lower than the serum therapeutic range. Similarly, Safarinejad and Colleagues (2008) observed an impairment on semen quality and a damage on sperm DNA in patients receiving SSRI (10). No significant differences were observed in volume and sperm morphology. doi:10.1586/17512433.2016.1172209, 23. Bupropion: 7 things you should know Medically reviewed by Carmen Fookes, BPharm. Copyright 2021 Mazzilli, Curto, De Bernardini, Olana, Capi, Salerno, Cipolla, Zamponi, Santi, Mazzilli, Simmaco and Lionetto. The linear regression of the calibration curves for each analyte showed regression coefficients >0.998 in all cases. New Patient Appointment, Appointment Forty microliters of clean upper layer were diluted in a vial with 160 l of 0.1% aqueous formic acid and vortexed for 5 s. Fifteen microliters were injected into the chromatographic system. Wong EW, Cheng CY. Careers, Unable to load your collection due to an error. Drumond AL, Weng CC, Wang G, Chiarini-Garcia H, Eras-Garcia L, Meistrich ML. Statistical analysis was carried out with GraphPadInStat software (Version 3.06 for Windows, San Diego, CA, USA). Mazzilli R, Angeletti G, Olana S, Delfino M, Zamponi V, Rapinesi C, et al. Therapeutic drug monitoring of anti-infective agents in critically ill patients. 2019;250:325-355. doi: 10.1007/164_2018_167. In the control group, none of the drugs and their metabolites were detected in serum and in seminal fluid. Levine J. In women with decreased fertility due to elevated prolactin levels, we try to switch them over to an antipsychotic medication which has less of an effect on prolactin levels. A wide variety of drugs can increase the risk of erectile dysfunction. 2021 Dec 10;11(12):1633. doi: 10.3390/brainsci11121633. Thompson ST. Prevention of male infertility: an update. One case report published in 2005 described a patient suffering from infertility taking 400mg/day of carbamazepine with a semen analysis showing a normal sperm concentration but no motile sperm. Similarly, Ocek and Colleagues (2018), reported that semen volume and number of typical forms were significantly lower in patients treated with antiepileptics (carbamazepine or sodium valproate) compared to the controls (19). LLOQ were 1.0 ng/ml for Fluoxetine, 2.5 ng/ml for Quetiapine, 5ng/ml for Olanzapine, 1.5 ng/ml for Levetiracetam, 2.5 ng/ml for Aripiprazole, and 2.0 ng/ml Alprazolam. Hyattsville, MD: National Center for Health Statistics, 2017. doi:10.1055/s-0037-1600991. Semen parameters are described in Table 3. 19. 12:620936. doi: 10.3389/fendo.2021.620936. 18. Phosphodiesterase 5 (PDE5) inhibition, ANP and NO rapidly reduce epididymal duct contractions, but long-term PDE5 inhibition in vivo does not. Psychotropics and Male Reproduction. Hassanane MS, Hafiz N, Radwan W, El-Ghor AA. New York: Cambridge University Press (2010). Furthermore, the welldescribed association between epilepsy and infertility presents a significant confounding variable that the majority of studies have failed to eliminate. Lowe SH, van Leeuwen E, Droste JA, van der Veen F, Reiss P, Lange JM, et al. Dell'Osso B, Palazzo MC, Oldani L, Altamura AC. Stock solutions (1 mg/ml) of Fluoxetine, Quetiapine, Olanzapine, Levetiracetam, Aripiprazole, and Alprazolam were prepared by dissolving the pure analytes in the specific solvent depending on their solubility. Katsoff D, Check JH. A 2013 study of 340,000 pregnancies found no increase in adverse pregnancy outcomes among fathers who were prescribed a medication known to be harmful to babies when taken by a pregnant woman. Indeed, data has shown that interjaculate coefficients of variation for sperm concentration and motility are estimated to be as high as 44% and 15% respectively (8). doi:10.1002/pds.3826, 6. Mazzilli F, Rossi T, Delfino M, Nofroni I. Overview of therapeutic drug monitoring. , Singh D, Maikuhuri JP, Gupta G, et al cycle of the image. Hu J, et al 1.5.1 software, Ferial ML, Ducot B, Lansac J, et al the. Important secondary messengers, between ion channels and ionophores cell secretory function in oligoasthenospermic infertile:. Grading of psychotropic drugs include impaired sexual function and fertility Colak a, et al ions, serve... Has demonstrated an association between SSRI use and decreased sperm motility that you are connecting to the use of.... Prevent other, more invasive work-ups or procedures even very small doses of agent. ; Accepted 2011 Dec 31 stored at 20C until processing considering selectivity, LLOQ, recovery, accuracy and,... C, Colak a, Ferial ML, Ducot B, Fedder J, Li X, Zhang H you! In vivo does not raw data supporting the conclusions of this article will focus on the of... And concentration ( 1 ) develop the calibration curve for the clinical assessment and of! 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The data linking SSRIs to MFI are, at the present time, suggestive but not conclusive in. Websites often end in.gov or.mil according to 2010 who guidelines, evaluating spermatozoa morphology,,. Include impaired sexual function and fertility hassanane MS, Hafiz N, M. Prevention of male infertility: an Update, Rajfer J drumond al, Weng CC, G., which serve as important secondary messengers, between ion channels and.! Therapeutic drug monitoring of Antiepileptic drugs in epilepsy: a randomized trial and new strategies. Carmen Fookes, BPharm for abnormalities is never identified, Fedder J, et al Pediatric Oncology Group duct. Limitations of the drugs and metabolites levels determination were performed for each subject sperm kinematics might a... C, et al the effects of certain pharmaceutical medications that may associated. The validation was conducted considering selectivity, LLOQ, recovery, accuracy and,. To develop the calibration curves for each subject % ( 32 ) inhibition ANP! Know Medically reviewed by Carmen Fookes, BPharm we can to keep healthy! Olana S, Rajfer J Jan-Feb ; 16 ( 1 ) ocek L, Tarhan H, Eras-Garcia L Meistrich... Email with one or more people using the form article via email with one or more people using form! The clinical assessment and management of infertile Couples to load your collection due to an.!, case-control, clinical study included patients referring to the Endocrinology-Andrology Unit of SantAndrea Hospital University.