Impact of Escitalopram on Sperm DNA Fragmentation

Overview

Double-blind placebo-controlled randomized trial of daily escitalopram for 6 weeks in healthy men with normal semen analyses and no psychiatric history of depression, bipolar, mania or suicidal ideation. Hormone profiles, semen analysis, sperm DNA fragmentation, and sexual function will be measured at baseline, after 6 weeks of therapy, and 4 weeks after discontinuation of therapy (10 weeks into study).

Full Title of Study: “Assessing the Impact of Escitalopram on Sperm DNA Fragmentation: A Randomized Placebo Controlled”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Participant, Investigator)
  • Study Primary Completion Date: December 2028

Detailed Description

SSRI medications, specifically escitalopram is a very commonly prescribed medication among men of reproductive age. Significant evidence exists that they may be harmful for paternal fertility potential in both animal and human studies. However, high quality data is lacking, particularly among commonly used SSRI's such as escitalopram. As such, it is important to properly evaluate the potential effect of escitalopram in a randomized placebo controlled fashion. Results will be important in guiding urologists, psychiatrists and family practitioners regarding discussion surrounding SSRI use in their patients interested in fertility.

Interventions

  • Drug: Escitalopram
    • 10mg by mouth daily for 6 weeks
  • Other: Placebo
    • matched placebo control by mouth for 6 weeks

Arms, Groups and Cohorts

  • Experimental: Escitalopram
    • 10mg by mouth daily for 6 weeks
  • Placebo Comparator: Placebo
    • Matched placebo control by mouth for 6 weeks.

Clinical Trial Outcome Measures

Primary Measures

  • Proportion of patients converted from normal to abnormal sperm DNA fragmentation from baseline to 6 weeks
    • Time Frame: 0 (baseline), 6 weeks
    • TUNEL assay for sperm DNA fragmentation

Secondary Measures

  • Absolute change in sperm DNA fragmentation
    • Time Frame: 0 (baseline), 6, 10 weeks
    • TUNEL assay for sperm DNA fragmentation
  • Changes in sperm motility
    • Time Frame: 0 (baseline), 6, 10 weeks
    • Percentage of motile sperm in semen analysis
  • Changes in progressive motility
    • Time Frame: 0 (baseline), 6, 10 weeks
    • Percentage of progressive motile sperm in semen analysis
  • Changes in viability
    • Time Frame: 0 (baseline), 6, 10 weeks
    • Percentage of viable sperm in semen analysis
  • Changes in concentration
    • Time Frame: 0 (baseline), 6, 10 weeks
    • Sperm concentration (number of sperm/mL) in semen analysis

Participating in This Clinical Trial

Inclusion Criteria

  • Normal semen analyses, or semen analyses with at least 5 million sperm – Normal TUNEL value (<7%) – Willing to engage in at least weekly sexual activity, with a partner or alone for the duration of the 10-week study Exclusion Criteria:

  • Azoospermia or severe oligospermia (<5million sperm per semen analysis) – Presently attempting to conceive pregnancy – Sexual dysfunction preventing ability to provide semen analysis throughout study or engage in weekly sexual activity – Current psychiatric disorder including: bipolar, mania, depression, generalized anxiety, social phobia, panic attacks, obsessive compulsive disorder, and schizophrenia. – Family history of bipolar disorder, or suicide (including 2nd degree relatives) – Present use of psychotropic agents (prescription or herbal) or anticonvulsants – Use of sleeping pills – Alcohol consumption greater that 2oz/day – Use of illicit drugs – Inability to read, follow instructions or complete questionnaires in English. – Use of hormonal medications in past 3 months (androgens, androgen blockade, anabolic steroids, estrogens, herbal) – Use of medications to enhance sexual function – History of chemotherapy or pelvic radiation – Use of Monoamine Oxidase inhibitors (MAOi's) or tricyclic antidepressants (TCAs) within 14 days – Liver disease

Gender Eligibility: Male

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Weill Medical College of Cornell University
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Jonathan Gal, MD, Principal Investigator, Weill Medical College of Cornell University
    • Peter Schlegel, MD, Principal Investigator, Weill Medical College of Cornell University
  • Overall Contact(s)
    • Grace Tan, 212-746-3208, grt2008@med.cornell.edu

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