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Hello, I'm 24 Year Old Guy, And My Doctor Prescribed

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Posted on Sun, 28 Oct 2018
Question: Hello, I'm 24 year old guy, and my doctor prescribed Zoloft (sertraline) 7 days ago for my depression, my depression symptoms are getting better but I got a very unpleasant side effect, my left testicle started to hurt since day 4 and I don't know if it's ever going to go away. I already tried Lexapro (escitalopram) when I was younger for few weeks and I experienced the same side effects. I don't know whats wrong with me, please help!
doctor
Answered by Dr. Vaishalee Punj (39 minutes later)
Brief Answer:
I will suggest semen analysis

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice.

There could be an structural issue with testes like testicular abscess, etc. I will suggest that you go for an ultrasound of both testes and also semen analysis. Since you are of younger age, I will suggest that you withdraw this medicine.

Meanwhile try alternative methods to deal with stress/depression like meditation.

There has been some documented evidence that anti-depressants (SSRIs) like sertraline, fluoxetine, escitalopram can have negative effect on testicular mass in some patients. In this study they evaluated their effect on spermatogenesis and found lower levels of sperms after taking these anti-depressants for 2 months.

Hope this helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vaishalee Punj (2 hours later)
Brief Answer:
OK you may half the dose

Detailed Answer:
Hi again

For now you may half the dose of Sertraline. I think pain will remain same or decrease a little after lowering the dose.

Currently I am more worried about your pain (or fertility) than depression. That is why, please get these tests done.

Dr Vaishalee

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Vaishalee Punj (2 minutes later)
I'm worried to quit the medication altogether, because I do feel like that it's helping me with my depression and anxiety. Maybe if I lower the dose than the pain will fade?
Answered by
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Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 3269 Questions

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Hello, I'm 24 Year Old Guy, And My Doctor Prescribed

Brief Answer: I will suggest semen analysis Detailed Answer: Hello and welcome to Ask A Doctor service. I have reviewed your query and here is my advice. There could be an structural issue with testes like testicular abscess, etc. I will suggest that you go for an ultrasound of both testes and also semen analysis. Since you are of younger age, I will suggest that you withdraw this medicine. Meanwhile try alternative methods to deal with stress/depression like meditation. There has been some documented evidence that anti-depressants (SSRIs) like sertraline, fluoxetine, escitalopram can have negative effect on testicular mass in some patients. In this study they evaluated their effect on spermatogenesis and found lower levels of sperms after taking these anti-depressants for 2 months. Hope this helps. Let me know if I can assist you further. Dr Vaishalee