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'This Is Us' Highlights a Little Known Antidepressant Side Effect

Sometimes the news isn’t as straightforward as it’s made to seem. Elizabeth Cassidy, The Mighty’s reporter, explains what to keep in mind if you see this topic or similar stories in your newsfeed. This is The Mighty Takeaway.

“This Is Us” never strays too far from real issues, albeit sometimes with a more dramatic representation, but, hey, it’s a TV show. In its three seasons so far, the show has tackled many tear-jerking storylines bringing awareness to aspects of life not everyone is familiar with. In season three, “This Is Us” tackles a little known — or talked about — side effect of antidepressants: fertility troubles.

When Kate and Toby learn about their infertility in the first episode, the doctor says Toby’s antidepressants may play a part in why they’re having trouble. Many people who take antidepressants know mental health medication can cause sex drive issues or make it difficult to get or maintain an erection.

What you may not be aware of, though, is the effect antidepressants have on a cisgendered man’s ability to get someone pregnant. Antidepressants can negatively impact sperm count, quality and motility (ability to move around), but research on this is sparingly low and comes with some drawbacks, according to a meta-analysis of related studies.

Depression itself can affect a man’s libido or ability to ejaculate, which could cause problems with trying to get pregnant. A few studies included in the meta-analysis have shown that antidepressants, specifically SSRIs, could impact a man’s fertility, but it’s hard for researchers to separate the effects of the antidepressants from the effects of depression. In some of those studies, however, men sometimes had an increase in fertility after stopping the medication.

After learning his medication might have been playing a role in their struggles, Toby quits his antidepressants cold turkey. For Toby, the decision to stop taking his medications seemed to be an easy one, though impulsive and extremely risky. Toby is always supporting Kate, who is taking a lot of risks to get pregnant. It makes sense Toby would think quitting his medications is only fair.

The problem is quitting antidepressants, specifically cold turkey, comes with a plethora of withdrawal symptoms that shouldn’t be taken lightly. Withdrawal or discontinuation symptoms can include flu-like symptoms, dizziness, agitation, headaches, nausea and “brain zaps,” which feel like electric shocks. You’re also more likely to have your depression symptoms return, as they did for Toby. Other people have severe reactions, like “Queer Eye’s” Jonathan Van Ness, who experienced psychotic depression after stopping his medications cold turkey.

It seems Toby felt a time constraint and wanted to do something quickly, but if you’re worried about infertility caused by antidepressants, it’s safer to taper off the medications, with the help of your doctor. According to researchers, fertility issues may lessen or subside after a few months of stopping the medication. Even if you stopped your medications abruptly, you’d still have to wait.

In the following episodes, we see Toby struggle with withdrawal from his antidepressants. He’s moody and loses his temper, and his depression comes back, though he hides it from Kate as long as possible. In episode five, Toby frantically heads to the pharmacy for a new prescription, but he’s informed he’ll have to talk to his doctor first.

Once Kate tells him she’s pregnant, he’s unable to keep it a secret any longer. Kate makes him a doctor’s appointment five weeks after stopping his medication. Though Toby begins his medication again, he still isn’t feeling better after a couple weeks. Antidepressants can sometimes take four or more weeks before someone feels the effects.

If you’re worried about fertility or other issues related to your antidepressants, it’s important to talk to your doctor. They can help you make an informed decision. If you need help talking to your doctor, The Mighty has a printable PDF to remind you of what you want to accomplish during your visit.

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