Background: Antidepressants are the foundation of the treatment of major depressive disorders. Despite the scientific evidence, there is still a sustained debate and concern about the efficacy of antidepressants, with widely differing opinions among the population about their positive and negative effects, which may condition people’s attitudes towards such treatments. Our aim is to investigate Twitter posts about antidepressants in order to have a better understanding of the social consideration of antidepressants. Methods: We gathered public tweets mentioning antidepressants written in English, published throughout a 22-month period, between 1 January 2019 and 31 October 2020. We analysed the content of each tweet, determining in the first place whether they included medical aspects or not. Those with medical content were classified into four categories: general aspects, such as quality of life or mood, sleep-related conditions, appetite/weight issues and aspects around somatic alterations. In non-medical tweets, we distinguished three categories: commercial nature (including all economic activity, drug promotion, education or outreach), help request/offer, and drug trivialization. In addition, users were arranged into three categories according to their nature: patients and relatives, caregivers, and interactions between Twitter users. Finally, we identified the most mentioned antidepressants, including the number of retweets and likes, which allowed us to measure the impact among Twitter users. Results: The activity in Twitter concerning antidepressants is mainly focused on the effects these drugs may have on certain health-related areas, specifically sleep (20.87%) and appetite/weight (8.95%). Patients and relatives are the type of user that most frequently posts tweets with medical content (65.2%, specifically 80% when referencing sleep and 78.6% in the case of appetite/weight), whereas they are responsible for only 2.9% of tweets with non-medical content. Among tweets classified as non-medical in this study, the most common subject was drug trivialization (66.86%). Caregivers barely have any presence in conversations in Twitter about antidepressants (3.5%). However, their tweets rose more interest among other users, with a ratio 11.93 times higher than those posted by patients and their friends and family. Mirtazapine is the most mentioned antidepressant in Twitter (45.43%), with a significant difference with the rest, agomelatine (11.11%). Conclusions: This study shows that Twitter users that take antidepressants, or their friends and family, use social media to share medical information about antidepressants. However, other users that do not talk about antidepressants from a personal or close experience, frequently do so in a stigmatizing manner, by trivializing them. Our study also brings to light the scarce presence of caregivers in Twitter.

Background: Antipsychotic medications are the first-line treatment for schizophrenia. However, non-adherence is frequent despite its negative impact on the course of the illness. In response, we aimed to investigate social media posts about antipsychotics to better understand the online environment in this regard.Methods: We collected tweets containing mentions of antipsychotic medications posted between January 1st 2019 and October 31st 2020. The content of each tweet and the characteristics of the users were analyzed as well as the number of retweets and likes generated.Results: Twitter users, especially those identified as patients, showed an interest in antipsychotic medications, mainly focusing on the topics of sexual dysfunction and sedation. Interestingly, paliperidone, despite being among one of the newest antipsychotics, accounted for a low number of tweets and did not generate much interest. Conversely, retweet and like ratios were higher in those tweets asking for or offering help, in those posted by institutions and in those mentioning cognitive complaints. Moreover, health professionals did not have a strong presence in tweet postings, nor did medical institutions. Finally, trivialization was frequently observed.Conclusion: This analysis of tweets about antipsychotic medications provides insights into experiences and opinions related to this treatment. Twitter user perspectives therefore constitute a valuable input that may help to improve clinicians' knowledge of antipsychotic medications and their communication with patients regarding this treatment.

BACKGROUND Paracetamol, codeine and tramadol are used to control mild pain. These drugs can be dispensed without a prescription or medical consultation and can be the gateway to the opioid addiction. OBJECTIVE Identify the perceptions and experiences of Twitter users in relation to these drugs. METHODS In this study we have focused on tweets posted in English or Spanish between January 2019 and December 2020 that mentioned paracetamol, tramadol or codeine. A total of 152.056 tweets were collected, but 49.462 tweets were excluded. We analyzed the content of the tweets according to the codebook we created for the study. In terms of type of user, we distinguished between patients, family members and friends, health care professionals or institutions. In terms of the content, if it was of a medical nature, we classified it depending on whether it made reference to the efficacy of a drug or its adverse effects. We also analysed if the information stated was scientifically correct identifying those tweets that included links to scientific papers. Moreover, in the non-medical content, we distinguished between four themes: 1) Commercial issues; 2)Economic aspects; 3) Solidarity; and 4) Trivialization. Finally, looking at the drug we classified the tweets in three categories: paracetamol, tramadol, and codeine. We selected a total of 1000 tweets for each drug which were classified manually. The goal of this initial tagging was to provide the data to train, test and validate Machine Learning classifiers so that all the extracted tweets classification could be inferred. RESULTS Of the total of tweets considered classifiable, 42,840 tweets mentioned paracetamol and 42,131 tweets mentioned weak opioids (tramadol or codeine). 73.10% of the tweets were posted by patients. However, tweets posted by healthcare professionals and health institutions obtained the highest ratio of like-tweet and tweet-retweet. The distribution of medical content for each drug was statistically different (p<0,001). Non-medical content was predominant (73.9%) in tweets regarding opioids while in paracetamol tweets medical content was predominant (66.8%). Of those tweets that included medical content, 80.8% mentioned the efficacy of the drug and of those, only 6.9% described a good or sufficient efficacy. Among the non-medical content, we also found statistically significant differences in the distribution between the different drugs (p<0.001). CONCLUSIONS Twitter users show great interest in finding relief from their pain, with their posts focusing more on the effectiveness of the painkiller than its potential side effects. The number of tweets posted in the first person about trivialization of the drug, specifically about recreational use, and the lack of awareness about the possible side effects is alarming.