Nearly four years after the launch of Russo-Ukrainian War, Russia is confronting a public health trend that reflects the prolonged psychological strain of conflict and economic hardship.
Official market data, independent media investigations and pharmaceutical industry figures show that Russians are consuming antidepressants at levels never previously recorded.
Sales have grown every year since the onset of the Covid-19 pandemic and have now exceeded the volumes seen during that earlier crisis.
What market research has revealed
Market research by the Russian consultancy DSM shows a sustained and steep upward trajectory in antidepressant sales over the past several years. In 2019, pharmacies sold 8.4 million packages nationwide.
That figure rose to 13 million in 2022, followed by 15.3 million in 2023 and 17.9 million in 2024. By last year, annual sales had reached 22.3 million packages, representing almost three times the volume recorded before the pandemic and the outbreak of the war.
The growth rate has also accelerated. In 2025, antidepressant sales expanded by 36 percent compared with the previous year, reported The Telegraph.
Another industry consultancy, RNC Pharma, reported a similar pattern and estimated that total annual sales reached 23.5 million packages, suggesting that the scale of consumption may be even higher than DSM’s figures indicate.
This expansion has pushed antidepressants into the top tier of Russia’s retail pharmaceutical market. Between January and October 2025 alone, pharmacies sold 19.1 million packages, with retail turnover peaking in October at 15.7 billion rubles, the highest monthly figure ever recorded for this category.
Moscow and the surrounding Moscow Oblast accounted for 31 percent of antidepressant sales by value, underlining the concentration of demand in major metropolitan areas where economic pressures, political controls and social change are felt acutely.
The trend stands in contrast with earlier periods of crisis. During the first year of the Covid-19 pandemic, pharmacies sold 7.9 million packages of antidepressants. In 2021, the figure rose to 9.2 million.
Both totals now appear modest compared with current levels. The steady escalation since 2022 suggests that the war and its social consequences have produced a deeper and more sustained psychological impact than the pandemic period.
Why Russians are succumbing to antidepressants
Since
the invasion of Ukraine, thousands of Russians have been detained for expressing opposition to the war. More than 20,000 people were arrested for anti-war activity between 2022 and last year, reported The Telegraph.
Stanislav Stanskikh, a Russia expert, linked the growing reliance on antidepressants to these broader pressures, telling The Telegraph, “The increase is attributed to reduced stigma around seeking mental health care, stockpiling amid sanctions, and broader economic and social shocks.”
“While the long-term mental health effects of authoritarian rule remain debated, the World Health Organisation has consistently shown that wars and other large-scale emergencies leave lasting psychological consequences, ranging from chronic distress to PTSD and severe mental disorders.”
He also pointed out the wider social environment shaping mental health outcomes, “In Russia, the intensified political repression and the persecution of religious and sexual minorities framed as ‘national security threats’, alongside the prolonged full-scale invasion of Ukraine, have created a climate of fear, intimidation, and uncertainty.”
“Rising antidepressant use may therefore reflect not only individual vulnerability, but also the broader psychological toll of living under sustained repression and war, compounded by international isolation, inflation, and economic decline.”
These pressures have filtered into everyday life. Polling data show that more than one-third of Russians believe the national economy is worsening, an increase of 10 percentage points compared with 2022.
Nearly half of respondents said it was an unfavourable time to look for work, while just under one-third reported difficulties affording food for themselves and their families.
Sanctions, disruptions to trade, and increased military spending have reshaped public finances and household budgets.
Funding allocations for welfare programmes, pensions and education have been redirected towards sustaining military operations, according to multiple reports. As social spending tightens, many households are facing increased pressure to meet basic needs.
Food price inflation has become a visible symbol of this strain. Since 2024, the cost of potatoes has surged by 167 per cent following failed harvests, according to Russian media reports.
For many families, staples such as potatoes represent a significant share of food consumption, making price rises particularly painful. Combined with stagnant or uneven income growth outside major cities, these increases have contributed to widespread anxiety about living standards.
Wage data illustrate the uneven nature of income distribution. As of January 2025, the average annual salary stood at around 83,000 rubles, with monthly earnings of approximately $908. In Moscow, average annual income reached about 106,000 rubles, reflecting higher pay levels in the capital.
At the same time, salaries in the defence sector and military have risen sharply due to recruitment incentives. A new recruit can earn more than $2,583 per month, along with a substantial signing bonus and additional compensation in the event of death or disability.
These incentives have drawn many into military service, but they also highlight the stark contrast between incomes linked to the war economy and those available in civilian sectors.
Independent counts compiled by Mediazona in collaboration with the BBC, using publicly available information, show that more than 160,000 Russian soldiers had been confirmed killed by the end of 2025.
Analysts caution that the true figure is likely significantly higher because many deaths are not publicly reported. Broader estimates suggest that total losses may have reached 352,000 when unconfirmed fatalities and wounded personnel are taken into account.
These figures do not capture the scale of psychological harm experienced by returning soldiers, their families, or communities affected by repeated mobilisation waves.
The war’s presence in Russian society is reinforced by recruitment campaigns, casualty announcements, and the visible impact on local communities. In contrast to the pandemic, which involved an “invisible” health threat, the war manifests through tangible losses that touch families directly.
During the pandemic, the Russian government reported around 130,000 deaths from Covid-19 between April 2020 and June 2021, although excess mortality estimates exceeded half a million over the same period.
While the pandemic disrupted daily life, the war has produced a more persistent backdrop of grief, uncertainty and risk, factors that mental health specialists link to long-term psychological distress.
What Russians are buying – and what they cannot find
Antidepressants are now among the most prominent products in Russian pharmacies, ranking second in retail sales by value. The most widely sold medications include sertraline, fluoxetine and amitriptyline.
Zoloft is currently the single highest-selling drug in the country, with fluoxetine and amitriptyline also among the most commonly purchased.
Despite state narratives critical of Western countries, many of the most widely used antidepressants in Russia are Western-developed selective serotonin reuptake inhibitors, including Zoloft, Prozac and Cipralex.
This reliance on imported or Western-origin medications has unfolded against a backdrop of recurring supply problems. Pharmacies in multiple regions reported shortages of essential drugs throughout 2025.
Complaints about unavailable medicines rose to 22,700 in the first nine months of the year, up from 19,100 over the same period in 2024.
More than 63 per cent of these complaints were linked to drugs missing from shelves, while other grievances related to refusals to issue prescriptions or lengthy delays in obtaining medications.
Access has been further complicated by a decline in the number of pharmacy outlets. From January to September 2025, Russia averaged around 84,900 pharmacies, representing a reduction of 754 locations compared with the previous year.
On average, each pharmacy served roughly 1,770 people. Industry experts have attributed the closures to a combination of market saturation, fiscal policy changes, and increasing pressure from large retail chains that smaller operators struggle to compete with.
For residents in smaller towns and rural areas, these closures can mean longer travel times and reduced access to medications, including antidepressants.
Although antidepressant prices in Russia are relatively low compared with many Western markets — with fluoxetine costing around $2 and a 28-pill pack of Zoloft priced at approximately $7.73 — affordability remains uneven.
Income disparities between Moscow and other regions mean that medication costs can represent a heavier burden for households outside major cities.
While demand for antidepressants continues to climb, access to consistent treatment is becoming more precarious in some regions.
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With inputs from agencies
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