Effects of antidepressants in adrenergic neurotransmission of human vas deferens

Objectives. To evaluate the effects of sertraline, fluoxetine, and amitript yline on the contractile responses of the human vas deferens muscle elicite d by norepinephrine, electrical field stimulation, and KCl, because the the rapeutic action of antidepressants may be accompanied by sexual dysfunction related to the contractility of the vas deferens smooth muscle. Methods, Ring segments of the epididymal part of the vas deferens were take n from 32 elective vasectomies and mounted in organ baths for isometric rec ording of tension. We then studied the effects of sertraline, fluoxetine, a nd amitriptyline on the neurogenic and agonist-induced contractile response s. Results. Amitriptyline caused concentration-dependent inhibition of neuroge nic and norepinephrine-induced contractions. In contrast, only the highest concentration (10(-5) M) of sertraline and fluoxetine reduced the adrenergi c contractions. The dihydropyridine calcium antagonist nifedipine (10(-6) M ) completely prevented the inhibitory effect of sertraline and fluoxetine o n neurogenic and norepinephrine-induced contractions but did not change the inhibition caused by amitriptyline. Sertraline, fluoxetine, and amitriptyl ine (all at 10(-5) M) attenuated contractions elicited by KCl and reduced c ontractions induced by CaCl2 in KCl-depolarized preparations, Conclusions. The results indicate that sertraline and fluoxetine inhibit va s deferens motility through inhibition of Ca2+ entry, with no effect on the adrenergic receptors, and amitriptyline acts as an adrenoceptor antagonist and inhibitor of the entry of calcium. UROLOGY 55: 592-597, 2000, (C) 2000 , Elsevier Science Inc.