Psychotropic drugs levels in seminal fluid, effects on semen quality and reproductive male health.
Infertility, which is defined as the failure to obtain a clinical pregnancy after at least 12 months of regular unprotected sexual intercourse, can be due to male factors in about 20-70% of cases, alone or in combination with female factors. The effects of many medications (i.e. chemotherapeutic agents, antihypertensive, 5alpha-reductase inhibitors, antibiotics and psychotropic drugs) on male reproductive system have been evaluated in several studies, with not univocal results. Psychotropic drugs are a heterogeneous group of medications with demonstrated negative effects on sexual function. Previous studies investigated the possible impact of some classes of psychotropics on semen alterations. In men, the most significant reproductive effects of psychotropics are on (1) increased PRL and gonadotropin levels with decreased testosterone; (2) sexual dysfunction, including negative effects on erection and ejaculation; and (3) decreased semen quality. Few in vitro and in vivo studies investigated the toxic effects of psychotropics in semen, showing a reduced sperm quality or increased DNA fragmentation associated with some classes of antidepressants and mood stabilizers. However, studies in humans are limited with no reported semen drugs levels and toxic mechanisms remains to be clarified.