Paxil is in a class of medications known as selective serotonin reuptake inhibitors, or SSRIs. The drugs are used to treat depression, anxiety, and various personality disorders. Paxil was recently reclassified as a Category D medication, meaning that there is positive evidence of birth defects when used during pregnancy, but may be acceptable if the drug is needed in a life-threatening situation or for a serious disease where safer drugs cannot be used or are ineffective.

All other SSRI medications are classified as Category C medications, meaning that either studies in animals have revealed birth defects and there are no controlled studies in women, or studies in women and animals are not available. These drugs are only given if the potential benefit justifies the potential risk to the fetus.

Paxil’s new safety label now warns men of possible problems with their role in conception. A known side effect of SSRI use in men is includes erectile dysfunction and premature ejaculation. But, according to a study published in the journal Fertility & Sterility, Paxil may also increase the level of “sperm fragmentation.” And this, the study suggests, may even cause major genetic damage to the sperm.

The study looked at 35 healthy men who took Paxil for five weeks. The men were tested both at the beginning of the five weeks and at the end. At the beginning of the study, only 10 percent showed DNA fragmentation. When the trial ended, half of the men tested positive for signs of abnormal DNA fragmentation. Fragmented DNA occurs when sperm DNA is missing pieces of genetic code. The men were retested after discontinuing Paxil, and their sperm appeared to return to normal.

Researchers did not speculate whether this sperm fragmentation might lead to birth defects, but suggested it may impair fertility.

Sources: FDA

SOURCE: Paxil and Pregnancy › Paxil may damage sperm, impair fertility in men

The findings are based on a study published in the online journal Fertility & Sterility. It is touted as one of the first studies to investigate the effects of antidepressants on sperm quality. While fertility wasn’t a direct focus of the study, “we can infer that as many as half of men taking SSRIs have a reduced ability to conceive,” says Dr. Peter Schlegel the study’s senior author.

More than a third of participants in the study also reported significant changes in erectile function and ejaculatory difficulties. Both sexual function and compromised sperm DNA returned to normal one month after discontinuation of the antidepressant.

Antidepressants also can have a more serious effect on fertility. Women who take antidepressants during the first trimester of pregnancy are at greater risk of having a baby with serious birth defects. Studies show that while a number of birth defects have resulted from use of antidepressants, paroxetine (Paxil, Seroxat) poses the greatest risk to an unborn child. Those defects include cardiac defects such as ventricular septal defects, pulmonary hypertension, omphalocele, and craniosynostosis.

Those who are pregnant or are considering pregnancy should consult with their doctors about any medications, including antidepressants, they are taking. In some cases, doctors may recommend an alternative that is safer for the unborn child and won’t interfere with conception.

SOURCE: Paxil and Pregnancy › Paxil, Seroxat may interfere with man’s ability to conceive