Trends in Brazilian market of antidepressants: A five-year dataset analysis

Abstract

Introduction: Depression is an emotional disorder associated with morbidities and disabilities worldwide. The growing use of antidepressants is a concern for health managers because there are still unanswered questions on the effectiveness and safety of these medicines. Drug sales have increased in Brazil in recent years, but investigations on antidepressants sales are not available. We aimed to describe the trends in the antidepressant commerce in Brazil in a five-year period.Materials and Methods: We performed an ecological study on antidepressant sales in Brazil, from November 2014 to October 2019, using data from IQVIA™, a data provider of pharmaceutical sales. Antidepressants were coded by the Anatomical Therapeutic Chemical classification system, and sales were presented in defined daily doses (DDDs) and DDDs per 1,000 inhabitants per day (DIDs). The results were expressed in absolute quantities and growth rates.Results: The analyzed dataset contained 23 active substances in 780 products. The total sales of antidepressants increased from 23.3 DIDs in November 2014 to 38.3 DIDs in October 2019 (p = 0.002). Selective serotonin reuptake inhibitors were the most sold category of drugs (+5.7 million DDDs) in the period. ‘Other’ antidepressants presented the largest growth rate (104.7%). Individually, the most sold active substance was escitalopram (+1.8 million DDDs), and vortioxetine had the largest growth rate (336.2%). Tricyclic sales remained unchanged, and monoamine oxidase inhibitors had low and even decreasing sales (−9.5%).Discussion: The total sales of antidepressants increased in Brazil from November 2014 to October 2019. The higher sale volumes of selective serotonin reuptake inhibitors and higher growth rate of ‘other’ antidepressants, with low sale volume of tricyclics and a decrease of monoamine oxidase inhibitors, suggest the replacement of older drugs by newer ones following a global trend. Therapeutic advances and commercial promotion efforts on new products might explain these findings.

Dispensing of psychotropic drugs in the Brazilian capital city before and during the COVID-19 pandemic (2018–2020)

“…Our results are expected considering the population's mental status. Furthermore, it agrees with the results presented in an ecological study, where this category was the main antidepressant sold for a total of 5 years period (Hoefler et al, 2022). This study's limitations include employing retrospective data, which might contain incomplete or missing data and filling errors due to lack of data insertion from public services; sanitary violations, such as sales without prescriptions, notably over the internet; variety in the quality of pharmacy attendant training that may contribute to the inability of some clerks to fill in the SNGPC worksheet, which does not happen at the time of dispensing but after, resulting in some of the SNGPC database's incomplete registration/lost data.…”

“…Frontiers in Pharmacology frontiersin.org Oliveira et al (2021)'s study in Ribeirão Preto, a city of 720 thousand inhabitants, described the Primary Care patients' consumption of psychotropic drugs and found that sertraline, clonazepam, and risperidone presented a higher consumption growth than the city's population growth rate between 2008 and 2012 (Oliveira et al (2021). These results collaborate with Hoefler et al ( 2022)'s exploratory ecological study that found antidepressant sales in Brazil from November 2014 to October 2019 increased from 23, 3 DHD in 2014to 38, 3 DHD in 2019 and that the selective serotonin reuptake inhibitors were the most sold antidepressant category (Hoefler et al, 2022).…”

“…Psychotropic medications are frequently prescribed in Brazil´s Federal District. The SNGPC data analyzed from 2018 to 2020 revealed an expressive increase in antidepressants after March 2020, particularly for desvenlafaxine (38.9%), escitalopram (29.1%), and sertraline (24.3%), like the results found by Hoefler et al ( 2022) (Hoefler et al, 2022), as well as the hypnosedative (anxiolytic) zolpidem (22.4%) -all statistically significant. These results imply that the isolation and social restriction negatively affected the mental health of the Brazilian Capital's residents.…”

Nanoencapsulation of Vaccinium ashei Leaf Extract in Eudragit® RS100-Based Nanoparticles Increases Its In Vitro Antioxidant and In Vivo Antidepressant-like Actions

“…In view of this scenario, there is a concern about the increasing antidepressant uses due to unanswered questions regarding their effectiveness and safety [ 6 ]. Currently, there are more than 20 antidepressant drugs in 780 medicines available in Brazil [ 6 ].…”

“…In view of this scenario, there is a concern about the increasing antidepressant uses due to unanswered questions regarding their effectiveness and safety [ 6 ]. Currently, there are more than 20 antidepressant drugs in 780 medicines available in Brazil [ 6 ]. Although, limited efficacy, pronounced delay to action onset, and undesirable effects (hypertensive crisis, sexual dysfunction, body weight change, and sleep disturbances) are observed in patients [ 6 , 7 ].…”