Nowadays, with the increased prevalence of depression in the societies, researchers have focused more attention on the long term effects of antidepressant medications on reproduction and sexual function. In vitro studies have shown that tricyclic antidepressants such as imipramine and nortriptyline impair sperm motility. Also, Serotonergic antidepressants such as fluoxetine and venlafaxine reduce male reproduction indirectly via effects on sexual desire (libido), erection and ejaculatory ability. Mechanisms of antidepressants are still unknown for changes in sperm function. Only neuroendocrine factors regulating the activity of the chemical mediators may have an effective role in the male sexual function. Most of the chemical mediators affect on hypothalamic-hypophyseal-gonadal axis and influence the spermatogenesis in men by this way. They can affect sexual arousal, erection, ejaculation and orgasm by sympathetic and parasympathetic regulation control and may influence fertility by their side effects on cholinergic and adrenergic receptors. In this review, the relationship between antidepressant medications and male reproduction, effects of antidepressant medications on the male sexual function and androgens levels will be discussed.