Is it safe for a prospective father to take sertraline (Zoloft), bupropion (Wellbutrin), and amphetamine (Adderall) while attempting to conceive?

Safety of Sertraline, Bupropion, and Adderall for Prospective Fathers During Conception

Prospective fathers can safely continue taking sertraline, bupropion, and Adderall while attempting to conceive, as there is no strong evidence that paternal use of these medications significantly impacts fertility or pregnancy outcomes. 1

Effects on Male Fertility

Sertraline (Zoloft)

• SSRIs like sertraline may negatively impact male fertility parameters in a dose and duration-dependent manner 2
• Studies have shown that SSRIs can decrease sperm count, viability, and disrupt morphological structure 2, 3
• These effects appear to be reversible upon discontinuation of the medication 3

Bupropion (Wellbutrin)

• Bupropion may be a preferred antidepressant for men planning conception due to its lower potential to cause sexual side effects 2
• It has fewer documented negative effects on male fertility parameters compared to SSRIs 2, 3

Amphetamine (Adderall)

• Limited specific data exists on Adderall's effects on male fertility 4
• The American College of Obstetricians and Gynecologists does not identify amphetamines as having significant negative effects on fertility when used therapeutically 5

Risk-Benefit Assessment

Mental Health Considerations

• Untreated ADHD and depression can significantly impact quality of life and functioning 4
• Discontinuing established effective treatments may lead to worsening mental health outcomes 4, 5

Paternal Medication Exposure

• A large Norwegian population-based study of 340,000 pregnancies found no increased risk of adverse pregnancy outcomes associated with paternal medication use before conception 1
• No significant association between paternal drug exposure and birth defects was found (OR 0.99,95% CI 0.94-1.0) 1

Recommendations for Prospective Fathers

Sertraline

• Consider discussing with healthcare provider about potential dose reduction if fertility issues arise 2, 3
• Benefits of continuing treatment for depression/anxiety likely outweigh theoretical risks to fertility 4

Bupropion

• Can be continued safely while attempting to conceive 2
• May be considered as an alternative if switching from SSRIs due to concerns about fertility 2

Adderall

• Can be continued at the lowest effective dose while attempting to conceive 4
• Consider intermittent use strategy if appropriate for symptom management 4

Important Considerations

• Individual response to medications varies, and some men may experience different effects on fertility parameters 2, 3
• If conception is delayed beyond 12 months of trying, consider semen analysis to rule out medication effects 3
• The benefits of maintaining mental health and functional status through continued treatment generally outweigh theoretical risks to fertility 4, 5

Monitoring

• Regular follow-up with mental health provider to ensure optimal dosing 4
• Consider timing conception attempts if medication adjustments are needed 2
• If fertility concerns arise, consultation with a reproductive specialist may be warranted 3