Does Citalopram affect fertility? (+3 side effects)

In this article, we will discuss the potential side effects of Citalopram on male and female fertility. We will further discuss some common side effects of Citalopram on fertility. Furthermore, we will discover the management of Citalopram if it leads to harmful effects on fertility.

Does Citalopram affect fertility?

Citalopram may affect fertility in some patients. Citalopram is not commonly associated with side effects affecting fertility but sexual dysfunction and decreased sex drive are linked with SSRI use.

However, it is important to note that many patients might have fertility issues while taking Citalopram while some may not experience any altering effects on fertility. This depends varyingly on patients and their response to the medications.

What does research suggest?

According to research studies, SSRIs can affect female and male fertility in different ways. These drugs are associated with sexual side effects such as decreased libido and erectile dysfunction in some patients (1,2).

The mechanism of SSRIs for sexual dysfunction is not completely understood. SSRIs have exhibited spermicidal side effects in some patients. However, stressful life events may have diminishing effects on sperm count and mobility in men (2).

Regarding women’s fertility, it has been reported that women taking SSRIs during their 2nd and 3rd trimesters may have pre-term birth and low-birth-weight infants. Furthermore, SSRIs during pregnancy may increase the chances of congenital abnormalities (1).

However, regarding male fertility, research suggests that Citalopram can affect sperm DNA integrity, morphology, concentration, and mobility without having major effects on sperm count (1).

In a research study, there was a case presented of a 30-year-old patient diagnosed with mixed depressive and anxiety disorder. The patient had abnormal reproductive-fluid parameters while he was being treated with Citalopram for almost 3 years(1).

However, the patient showed significant improvement in sperm morphology, concentration, and mobility after discontinuing his treatment from Citalopram after 4 months (1).

In another report, two depressed patients were diagnosed with oligozoospermia. Citalopram was prescribed to one patient, while the other was given Sertraline.  After discontinuation of SSRIs in both patients, their reproductive-fluid quality significantly improved (1).

The research conducted on male fertility regarding the use of SSRIs has shown its tremendous impact on sperm transport but did not show any harmful effects on spermatogenesis (1).

Therefore, it can be stated that SSRIs including Citalopram and Sertraline affect fertility. SSRIs are associated with dose and duration-dependent adverse effects on male fertility parameters (3).

Potential side effects of Citalopram on fertility

Following are the potential side effects of Citalopram on fertility (4):

Sexual dysfunction

Citalopram may be associated with sexual dysfunction in both males and females. This medication is associated with decreased libido leading to decreased sex drive and sexual dysfunction in both men and women.

Pregnancy complications

Citalopram and other SSRIs have been associated with pregnancy-related complications. Citalopram is declared pregnancy category-C medication by the FDA (4).

Prolonged hospitalization, tube feeding, and respiratory difficulties have been reported in infants who were exposed to SSRIs during the third trimester. Therefore, careful use of Citalopram is advised during pregnancy to avoid complications (4).

Alternative antidepressants to use if Citalopram causes fertility issues

If you are facing fertility issues while taking Citalopram, then consult your doctor. Your doctor may recommend switching to another antidepressant which is not commonly associated with sexual side effects and does not induce fertility issues.

Atypical antidepressants have a lower incidence of affecting fertility in both men and women. The atypical antidepressants such as Bupropion and Wellbutrin are least associated with causing sexual side effects.

Bupropion and Wellbutrin are sometimes also prescribed to patients who are having fertility issues with the use of SSRIs. If Citalopram monotherapy is causing sexual dysfunction then your doctor might add atypical antidepressants to your regimen to prevent SSRIs-induced sexual side effects.

How to tackle Citalopram-induced fertility issues?

If you are taking Citalopram and it is affecting your fertility, then you should consult your healthcare provider. You need to discuss your side effects and symptoms related to sexual functionality and abnormalities with your doctor to seek medical assistance.

Depending on your evaluation, your healthcare provider should tamper with the medication dose or suggest an alternative antidepressant to treat psychosis without affecting your fertility.

However, if you are facing certain fertility-associated side effects with Citalopram, do not abruptly stop taking the medication as it may have withdrawal effects. Rather discuss your case with your doctor.

Conclusion

In this article, we have discussed in great detail the impact of SSRIs particularly Citalopram on your fertility. We have discovered some potential side effects that are caused by Citalopram on the fertility of both men and women. We have discovered ways to tackle Citalopram-induced infertility.

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References

1.-

Xu J, He K, Zhou Y, Zhao L, Lin Y, Huang Z, Xie N, Yue J, Tang Y. The effect of SSRIs on Semen quality: A systematic review and meta-analysis. Front Pharmacol. 2022 Sep 14;13:911489. doi: 10.3389/fphar.2022.911489. PMID: 36188547; PMCID: PMC9519136. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9519136/

2.-

Nørr, L., Bennedsen, B., Fedder, J., & Larsen, E. R. (2016). Use of selective serotonin reuptake inhibitors reduces fertility in men. Andrology, 4(3), 389–394. https://onlinelibrary.wiley.com/doi/full/10.1111/andr.12184

3.-

Jovana Z. Milosavljević, Miloš N. Milosavljević, Petar S. Arsenijević, Milica N. Milentijević & Srđan M. Stefanović (2022) The effects of selective serotonin reuptake inhibitors on male and female fertility: a brief literature review, International Journal of Psychiatry in Clinical Practice, 26:1, 43-49.  https://doi.org/10.1080/13651501.2021.1872647

4.-

Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. [Updated 2021 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482222/

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