Depression Clinical Trial
Official title:
Impact of Duloxetine on Male Fertility
The investigators are conducting a placebo-controlled, randomized control trial with duloxetine in healthy, fertile men not previously on any antidepressants. Participants will be randomized to either the duloxetine or placebo groups for 6 weeks. The investigators will assess changes in sperm DNA fragmentation at 0, 2, 6, 8, and 10 weeks. Other outcomes measured will include semen parameters (sperm concentration, motility, morphology), hormone levels (testosterone, estrogen, prolactin, LH, FSH), and sexual function (IIEF and MSHQ) surveys.
Antidepressant medications are commonly prescribed in the USA not only for depression, but
also for anxiety disorders such as generalized anxiety disorder and obsessive-compulsive
disorder, premature ejaculation, post-traumatic stress disorder, and neuropathic pain.
Despite being widely prescribed in the United States in men of reproductive age, the impact
of antidepressants on fertility has not been extensively studied.
After noticing worsened semen parameters in men on anti-depressants, the investigators
performed the first prospective study to demonstrate a deleterious impact of selective
serotonin reuptake inhibitors (SSRI) on sperm DNA integrity, which has been linked to
reproductive outcomes. Further small studies have corroborated the negative impact of SSRIs
on male fertility, as assessed by semen parameters and/or sperm DNA integrity.
No studies have examined the impact of a newer, but similar, class of antidepressant - the
serotonin-norepinephrine reuptake inhibitor (SNRI). Like SSRIs, SNRIs inhibit the reuptake of
serotonin, but also act on norepinephrine. The use of SNRIs has increased recently due to
their slightly improved efficacy profile when compared to SSRIs. Duloxetine is an SNRI and is
one of the most commonly prescribed anti-depressants in the United States.
The investigators are conducting this trial to determine whether or not the administration of
duloxetine will result in a deterioration in sperm DNA fragmentation in healthy, fertile men.
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