Cargando…

Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?

The aim of this observational study was to develop a new quantitative liquid chromatography-mass spectrometry (LC-MS/MS) method for Therapeutic-Drug-Monitoring (TDM) of psychotropic drugs in seminal fluid to investigate potential gonadotoxic effects in patients with reduced fertility. After the vali...

Descripción completa

Detalles Bibliográficos
Autores principales: Mazzilli, Rossella, Curto, Martina, De Bernardini, Donatella, Olana, Soraya, Capi, Matilde, Salerno, Gerardo, Cipolla, Fabiola, Zamponi, Virginia, Santi, Daniele, Mazzilli, Fernando, Simmaco, Maurizio, Lionetto, Luana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992038/
https://www.ncbi.nlm.nih.gov/pubmed/33776918
http://dx.doi.org/10.3389/fendo.2021.620936
_version_ 1783669294991671296
author Mazzilli, Rossella
Curto, Martina
De Bernardini, Donatella
Olana, Soraya
Capi, Matilde
Salerno, Gerardo
Cipolla, Fabiola
Zamponi, Virginia
Santi, Daniele
Mazzilli, Fernando
Simmaco, Maurizio
Lionetto, Luana
author_facet Mazzilli, Rossella
Curto, Martina
De Bernardini, Donatella
Olana, Soraya
Capi, Matilde
Salerno, Gerardo
Cipolla, Fabiola
Zamponi, Virginia
Santi, Daniele
Mazzilli, Fernando
Simmaco, Maurizio
Lionetto, Luana
author_sort Mazzilli, Rossella
collection PubMed
description The aim of this observational study was to develop a new quantitative liquid chromatography-mass spectrometry (LC-MS/MS) method for Therapeutic-Drug-Monitoring (TDM) of psychotropic drugs in seminal fluid to investigate potential gonadotoxic effects in patients with reduced fertility. After the validation of the LC-MS/MS method for psychotropics’ levels determination in seminal fluid, we included 20 male partners of infertile couples with idiopathic and/or unexplained male infertility, treated with psychotropic medications for more than 3 months and 10 untreated fertile controls. General and andrological clinical examination, semen analysis and seminal drugs, and metabolites levels determination were performed for each subject. Of the 20 patients included, 6 were treated with antidepressants; 4 with benzodiazepines and 10 with antipsychotics. Seminal drugs and metabolites levels were detectable in all samples. In particular, alprazolam, olanzapine, and levetiracetam showed seminal and serum similar concentrations, while fluoxetine, quetiapine, and aripiprazole were detectable, but seminal levels were significantly lower than the serum therapeutic range. Sperm progressive motility was significantly reduced in subjects treated with psychotropic drugs compared to the untreated controls (p = 0.03). Sperm concentration and progressive motility were significantly reduced in subjects treated with antipsychotics compared to the untreated controls and to the other classes of psychotropics (p < 0.05). In conclusion, this study reports a validated LC-MS/MS method for the detection of seminal psychotropic levels and preliminary data suggesting a potential correlation of seminal psychotropics with alterations of sperm concentration and motility. Pending larger studies, semen TDM might represent a new pivotal tool in the clinical management of reduced fertility in males treated with psychotropic medications.
format Online
Article
Text
id pubmed-7992038
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-79920382021-03-26 Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis? Mazzilli, Rossella Curto, Martina De Bernardini, Donatella Olana, Soraya Capi, Matilde Salerno, Gerardo Cipolla, Fabiola Zamponi, Virginia Santi, Daniele Mazzilli, Fernando Simmaco, Maurizio Lionetto, Luana Front Endocrinol (Lausanne) Endocrinology The aim of this observational study was to develop a new quantitative liquid chromatography-mass spectrometry (LC-MS/MS) method for Therapeutic-Drug-Monitoring (TDM) of psychotropic drugs in seminal fluid to investigate potential gonadotoxic effects in patients with reduced fertility. After the validation of the LC-MS/MS method for psychotropics’ levels determination in seminal fluid, we included 20 male partners of infertile couples with idiopathic and/or unexplained male infertility, treated with psychotropic medications for more than 3 months and 10 untreated fertile controls. General and andrological clinical examination, semen analysis and seminal drugs, and metabolites levels determination were performed for each subject. Of the 20 patients included, 6 were treated with antidepressants; 4 with benzodiazepines and 10 with antipsychotics. Seminal drugs and metabolites levels were detectable in all samples. In particular, alprazolam, olanzapine, and levetiracetam showed seminal and serum similar concentrations, while fluoxetine, quetiapine, and aripiprazole were detectable, but seminal levels were significantly lower than the serum therapeutic range. Sperm progressive motility was significantly reduced in subjects treated with psychotropic drugs compared to the untreated controls (p = 0.03). Sperm concentration and progressive motility were significantly reduced in subjects treated with antipsychotics compared to the untreated controls and to the other classes of psychotropics (p < 0.05). In conclusion, this study reports a validated LC-MS/MS method for the detection of seminal psychotropic levels and preliminary data suggesting a potential correlation of seminal psychotropics with alterations of sperm concentration and motility. Pending larger studies, semen TDM might represent a new pivotal tool in the clinical management of reduced fertility in males treated with psychotropic medications. Frontiers Media S.A. 2021-03-11 /pmc/articles/PMC7992038/ /pubmed/33776918 http://dx.doi.org/10.3389/fendo.2021.620936 Text en Copyright © 2021 Mazzilli, Curto, De Bernardini, Olana, Capi, Salerno, Cipolla, Zamponi, Santi, Mazzilli, Simmaco and Lionetto http://creativecommons.org/licenses/by/4.0/ his is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Mazzilli, Rossella
Curto, Martina
De Bernardini, Donatella
Olana, Soraya
Capi, Matilde
Salerno, Gerardo
Cipolla, Fabiola
Zamponi, Virginia
Santi, Daniele
Mazzilli, Fernando
Simmaco, Maurizio
Lionetto, Luana
Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?
title Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?
title_full Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?
title_fullStr Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?
title_full_unstemmed Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?
title_short Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?
title_sort psychotropic drugs levels in seminal fluid: a new therapeutic drug monitoring analysis?
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992038/
https://www.ncbi.nlm.nih.gov/pubmed/33776918
http://dx.doi.org/10.3389/fendo.2021.620936
work_keys_str_mv AT mazzillirossella psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT curtomartina psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT debernardinidonatella psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT olanasoraya psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT capimatilde psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT salernogerardo psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT cipollafabiola psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT zamponivirginia psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT santidaniele psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT mazzillifernando psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT simmacomaurizio psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis
AT lionettoluana psychotropicdrugslevelsinseminalfluidanewtherapeuticdrugmonitoringanalysis