Experts say people can face serious side effects if they abruptly stop taking their antidepressant medications.
What happens if you suddenly stop taking your antidepressant medication?
NBC’s hit television series “This Is Us” is tackling that issue and the serious side effects that go along with antidepressant withdrawal.
The new season finds the Pearson family coping with news that Kate (Chrissy Metz) and Toby (Chris Sullivan) have decided to attempt having a family with fertility assistance.
Doctors are not giving the couple great odds of success.
In fact, when Kate and Toby meet with a fertility doctor, she refuses to work with them, citing health concerns because of Kate’s obesity.
However, the doctor later agrees to take on their case, still cautioning them that they have a 90 percent chance of failure.
In her warnings to Kate and Toby, the doctor acknowledges that Toby’s long-term use of antidepressants is a concern, much like Kate’s weight issues.
Antidepressants, which are used to balance brain chemicals and reduce symptoms of anxiety or depression, may cause some sexual side effects. These include decreased libido, reduced chances of erection, and low sperm count.
Toby began using the medication after becoming severely depressed when his wife left him.
When the fertility doctor suggests his use of antidepressants could impact their fertility chances, Toby flushes his bottle of Zoloft down the toilet, quitting his medication cold turkey.
This, it turns out, could become one of the most pressing storylines in the new season of the show.
That’s because quitting antidepressants abruptly can be dangerous, even deadly.
“Unless there is a medical emergency where a doctor recommends you abruptly stop your medications, there is no good that comes from abruptly discontinuing medications,” said Dr. Matthew Goldenberg, DO, associate medical director of the Center for Professional Recovery at New Vista Behavioral Health in Costa Mesa, California.
“The goal is to stabilize on a dose for four to six months and then slowly decrease the medications over time. This gives you the best chance of sustaining the improvements you have made and not experiencing withdrawal,” Goldenberg told Healthline.
Withdrawal is what viewers appear to be watching Toby undergo this season.
Indeed, he’s seen researching the side effects of antidepressants.
His typically calm demeanor is replaced by one that’s edgy and a bit raw.
Antidepressant withdrawal is a real phenomenon, one that more than half of all people who stop taking antidepressants will experience, according to British research.
What’s more, nearly half of those who experience symptoms of withdrawal, or antidepressant discontinuation syndrome, will describe their symptoms as “severe.”
“When reducing the dose or stopping antidepressants, some people can experience physical, and emotional symptoms, including but not limited to dizziness, fatigue, general malaise, agitation, increased anxiety, and even numbness or tingling,” said Dr. Ravi N. Shah, assistant professor of psychiatry and medical director of the psychiatry faculty practice organization at Columbia University Medical Center in New York.
“The most common symptoms I hear in my office are just feeling very out of sorts and emotionally unwell,” Shah told Healthline.
Suicidal thoughts may also crop up in people going through withdrawal from antidepressants. This makes the choice to stop using the medication potentially life-threatening.
In episode three, Toby is seen shaking his knee nervously as he and Kate’s brother Randall (Sterling K. Brown) wait for news from Kate’s doctor. Toby confesses to Randall he takes antidepressants and Randall admits he’s used anti-anxiety medication.
“Without it, life gets pretty scary,” Toby tells his brother-in-law.
First things first. You need to talk with your doctor, Goldenberg says.
“You should always speak to your psychiatrist and develop a plan to safely and slowly help you get off the medications,” he advised.
You may still experience symptoms of withdrawal, but doctors can work with you to taper your level of medication so the chances of withdrawal are slimmer, and the impact may be reduced.
In most cases, antidepressant withdrawal is difficult but temporary.
“Withdrawal can indeed be quite challenging, but I do also emphasize to patients that the worst symptoms are often in the first week,” Dr. Alex Dimitriu, a California-based board-certified psychiatrist, told Healthline. “Usually, they are not indicative of how things will continue.”
Instead of quitting abruptly as Toby did, your doctor may work with you to lower your dosage gradually. When you stabilize at one dosage, you may be scaled back to a lower dose.
This step-by-step approach helps you learn to manage the influx of depression or anxiety symptoms with the effects of chemical changes in your brain.
“The good news is that this is entirely manageable, and if your goal is to come off the antidepressant, in the vast majority of cases, you will be able to do so without lingering physical symptoms,” Shah said.
Toby took his decision to quit his antidepressants into his own hands. He did not consult his doctor. He didn’t even tell Kate.
In one of the show’s signature flash-forward moments, it’s evident that the implications from his decision will become clear soon. Toby is seen lying, almost motionless, in his dark bedroom. Kate enters and tells him that his doctor wants to see him to discuss adjusting his medication level.
“You must consider the possibility that the medication was working exactly as it should,” Shah said. “In these cases, you may want to reconsider the benefits versus the risks of staying on the mediation.”
That’s why Shah stresses talking with your doctor before you make the decision to quit.
“Fortunately, in most cases, things do improve after the withdrawal period,” Dimitriu said. “But they also return to where they were before the medication, which may not be a good place.”