Paxil Reportedly Linked to Sexual Dysfunction

Milwaukee, WIAmong the list of drug side effects that people might not expect to read about, sexual dysfunction probably ranks close to the top. However, some medications, including antidepressants such as Paxil, have reportedly been linked to an increased incidence of sexual dysfunction. Furthermore, a study has linked Paxil to a risk of impaired fertility in men, although experts say more research must be done on this reported link.

According to the prescribing information for Paxil, (found online at fda.gov), changes in sexual desire, sexual performance and sexual satisfaction "may also be a consequence of pharmacologic treatment. In particular, some evidence suggests that selective serotonin reuptake inhibitors (SSRIs) can cause such untoward sexual experiences."

The prescribing information further notes that it is difficult to obtain reliable estimates of the incidence and severity of sexual issues because patients and physicians may be reluctant to discuss them. "Accordingly, estimates of the incidence of untoward sexual experience and performance cited in product labeling are likely to underestimate their actual incidence."

An article published in the September, 2006, issue of the American Journal of Psychiatry notes that sexual dysfunction associated with medications, "is characterized by a disturbance in the processes that characterize the sexual response cycle."

The article, authored by Richard Balon, M.D., states that use of early antidepressants (the first generations of antidepressants) resulted in occasional reports of sexual dysfunction. However, with the newer antidepressants, including SSRIs, the reports of sexual side effects have increased. Although he says that reasons for this increase are not clear, some possible explanations include more liberal use of antidepressants for other conditions, treatment of less severe depression than before, more sophisticated evaluation of side effects and, possibly, that patients taking SSRIs experience more sexual dysfunction than patients taking tricyclic antidepressants.

Meanwhile, a study published in the September, 2008, issue of NewScientist suggested that SSRIs, including Paxil, could be impairing men's fertility by causing damage to their sperm's DNA. For the study, the research team gave 35 healthy men doses of paroxetine (sold as Paxil or Seroxat) for five weeks and examined their sperm both before treatment began and four weeks in.

Researchers found that on average, "the proportion of sperm cells with fragmented DNA rose from 13.8 per cent before taking paroxetine to 30.3 per cent after just four weeks." According to the article, fertility specialists regard "a fraction of 30 per cent of sperm with DNA damage as being 'clinically significant'."

Experts pointed out that more studies of the long-term effects of SSRIs on sperm are necessary.