War sends Russia into a spiral of antidepressants
Sales of drugs to treat anxiety and other mental health issues have tripled since the pandemic, and grow every year
Russians consume more antidepressants every year, topping even pandemic-era levels. Between an endless war against Ukraine, an economic crisis stemming from that conflict and the political repression, the country has registered record sales of the medications every year since the eruption of Covid-19 in 2020. Last year’s total nearly tripled pharmaceutical consumption in 2019, the last year before this ill-fated decade.
Data shared by the Russian consultancy DSM point to an increasingly serious situation. In 2025, the year in which peace negotiations were unsuccessfully reinitiated between Russia, Ukraine and the United States, sales of antidepressants grew 36% compared to 2024.
That adds up to 22.3 million packages every year, for a population of around 143 million. In fact, the war has led to greater dependence on the medications than during the Covid crisis. For comparison, in 2021, just before the offensive against Ukraine began in February 2022, pharmacies sold 9.2 million packages in Russia. During the pandemic, the first major crisis of the decade, that total stood at 7.9 million, a half-million fewer than in 2019, the last “quiet” year.
Last year, the Russian pharmaceutical industry grew to $273 million. Another consultant agency, RNC Pharma, shared a report with the Russian newspaper RBK that pointed to a similar tendency, though it raised the estimation of antidepressants sold to 23.5 million last year.
The war that Russia began nearly four years appears to have had a larger emotional impact on its population than the coronavirus, and era during which the Kremlin’s response was notably lax, with barely any lockdowns. According to the Russian government, some 130,000 citizens died from the virus between April 2020 and June 2021, though the excess death rate rose above a half-million individuals during that same period.
It’s possible that war has a larger presence in Russian daily life than the invisible enemy of Covid-19. Independent Russian publication Mediazona and the BBC use public sources to document the names of Russian soldiers who have died since the beginning of the war. According to these numbers, the Russian offensive’s intensification since Trump’s return to power in the United States, by the end of 2025, has led to more than 160,000 dead, though the total is ostensibly “much larger”, due to the number of names that have not been made public. According to estimates, losses have reached 352,000, without counting those who have been wounded and victims of post-traumatic mental health issues.
According to DSM, the highest-selling medication in the country is serotonin inhibitor Zoloft, whose patent belongs to U.S. firm Viatris. Other drugs at the top of the list are amitriptyline and fluoxetine.
“The issue with anti-depressants is that they are sometimes used as a first option when they are not necessary, when there is a different kind of treatment, as in cases of mild to moderate depression,” says Irene de la Vega Rodríguez, a clinical psychologist at the San Carlos Clinical Hospital in Madrid.
“First, before trying a pharmaceutical, it’s important to treat patients with psychotherapy. And another problem is the tendency to medicalize the problems of everyday life, social issues or issues that a pharmaceutical product is rarely going to fix,” says the specialist.
Medication prices vary widely from one country to another. Fluoxetine in Russia costs about $2, while a package of 28 Zoloft pills can cost around $7.73. The average yearly Russian wage stood at around 83,000 rubles (nearly $10,900) as of January 2025, with monthly pay around $908, according to Russian headhunter site HH. Those numbers differ dramatically from region to region. In Moscow, one of the best-paid Russian cities and the capital of oligarchs, Mercedes and luxury items, the average salary reached 106,000 rubles ($14,000) per year.
Those figures stand in spite of the fact that salaries have skyrocketed amid an inflationary crisis due to contracts offered by the military industry and the armed forces. A recruit earns more than $2,583 a month, plus a first-time signing bonus that can be around $26,000, in addition to a death or disability bonus that pays out to family members if they are killed in action.
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