Antidepressant sales keep rising in Russia, but doctors say it doesn't simply mean more depression

Russian media regularly report that antidepressant sales in the country keep growing. Specialists say the trend stems from several factors and doesn't necessarily mean depression rates are simply climbing.

Multiple factors behind the growth

It's possible that more people are indeed developing depression, partly due to recent years' events. However, antidepressants are also prescribed for other conditions, including post-traumatic stress disorder, which can be triggered by war.

Doctors note that more people are now recognizing their symptoms as signs of a mental disorder and are less ashamed to see a psychiatrist or take antidepressants, as the stigma around psychiatry gradually fades. Depression diagnoses in Russia were already rising before the full-scale invasion of Ukraine, and that trend continued through 2022, though more recent official data isn't available.

Another factor is cost: since quality psychotherapy is expensive, people with mild depressive episodes often opt for the cheaper option of antidepressants, even though psychotherapy is recommended as the first-line treatment. Additionally, Russia's latest clinical guidelines note that antidepressants are also used to treat conditions such as bed-wetting in children, migraines, irritable bowel syndrome, and chronic pain — which may explain why doctors outside psychiatry increasingly prescribe them.

Stopping treatment and side effects

Doctors say antidepressants can be discontinued, but this must be done gradually, sometimes very slowly. About 85% of patients go through this process without major issues. Problems are more common among those who stop too quickly, who were on high doses, or who switch to a drug with a different mechanism of action. Common withdrawal symptoms include dizziness, headache, nausea, insomnia, and irritability, which usually resolve within days but can sometimes last weeks or months.

Side effects occur in about half of cases when starting the medication, and doctors stress the importance of working out a plan with a specialist, since the risk of suicidal thoughts rises during the first weeks of treatment. Combining antidepressants with alcohol isn't recommended, as it can intensify side effects such as drowsiness and dizziness.