Use of drugs for mental health grows in Brazil; Experts warn of care

The commercialization of antidepressants and mood stabilizers grows every year in Brazil. Data from the Federal Council of Pharmacy indicate that the sale of these drugs grew by about 58% between 2017 and 2021.

Prior to the Covid-19 pandemic, an estimated 193 million people had major depressive disorder and 298 million people had anxiety disorders in 2020. After adjusting for the pandemic, initial estimates show a jump to 246 million for major depressive disorder and 374 million for anxiety disorders.

Recent estimates suggest that one in eight people, nearly a billion individuals worldwide, are living with a mental health condition. In the first year of the pandemic, there was an estimated 25% increase in the prevalence of depression and anxiety worldwide.

Faced with the increase in demand for drugs that help support mental health conditions, experts highlight the importance of medical and therapeutic monitoring and the risks of indiscriminate use of drugs.

How the drugs work

Professor of Epidemiology at the Federal University of Sergipe and consultant to the Federal Council of Pharmacy, Wellington Barros da Silva, explains how antidepressants and mood stabilizers work in the human body.

“These medications, in general, alter what we call chemical mediators, substances that our body produces, responsible for mood stages. Like, for example, dopamine and serotonin, important neurotransmitters”, he says.

The production of these substances by the human body directly influences people’s mood. Problems such as depression and anxiety alter the functioning of chemical mediators and medications act by regulating the production of these mediators, with the aim of stabilizing the emotional condition.

Anxiolytics and sedatives will act first in the brain, where there are specific receptors for the drugs, as explained by researcher Alline Cristina de Campos, a professor at the Department of Pharmacology at the Faculty of Medicine of Ribeirão Preto at the University of São Paulo (USP).

“What the drugs will do is facilitate the inhibition of our brain through a neurotransmitter called GABA and decrease anxiety”. GABA is aminobutyric acid, the main inhibitory neurotransmitter of the central nervous system, which acts as a relaxation inducer and concentration facilitator.

Experts warn that antidepressants and anxiolytics act directly on the nervous system and, therefore, should be used with care. Medical follow-up is essential to understand and control the effects of these drugs.

“When we are under the effect of this medication for a long time, our body gets used to it and it is as if our brain starts to produce smaller amounts of these neurotransmitters. If you abruptly withdraw this medication, it will cause the absence of this neurotransmitter, not completely, but at the level that our brain needs”, warns Aline. Thus, an adaptation process is necessary for readaptation of the brain.

Risks of indiscriminate use

Antidepressants or anxiolytics can cause patient dependence if used indiscriminately.

“When there is a change in the production of these substances in the body, it tries to rebalance itself by reacting to the medicine, because it is a strange substance in our body”, explains Silva.

Dependence goes through several changes in the biological mechanism of the human organism. The weaning process, which consists of a gradual reduction in the dose to minimize the effects of the medicine, is also essential.

“It is the abusive and often unnecessary use of medication that induces you to cause an imbalance between the use of that medication and the body’s response. This will provoke the phenomenon that we call dependence”, points out Silva.

Medical follow-up is necessary to determine the type of medication, dosage and duration of use, according to each clinical condition. The prescription can be made by the psychiatrist.

The pandemic was also a considerable factor in the increase in the commercialization of these drugs. From 2019 to 2020, the growth was 17% and, from 2020 to 2021, it was 12%.

“It is an indication that the pandemic actually affected people’s mental health, probably due to some issues, such as the confinement we were forced to stay in and the very anxiety situation that is caused by a disease that we do not care about. I didn’t have any knowledge or anything”, says Silva.

Signs that mental health is not going well

Symptoms of mental disorders such as anxiety or depression are diverse and can vary from one person to another. However, mental health experts cite some signs that may indicate the need for specialized help.

Psychologist Maycon Rodrigo Torres, a member of the Laboratory of Psychoanalysis and Social Bonding at the Fluminense Federal University (UFF) and professor of psychology at Faculdade Maria Thereza (Famath), points out that people should be aware of the quality of social relationships.

“It is necessary to observe how the bonds of work, friendship, relationships are maintained and how healthy these bonds are. It is important to understand how much the presence among other people becomes something that gives pleasure and well-being, ”she says.

For the psychologist, isolation is a characteristic that must be carefully evaluated. According to him, it is possible to be isolated even in front of meetings with family or friends.

The specialist says that the psychological evaluation considers the individual in his particularities in an analysis of what is common and what can be a sign of illness.

“We usually work, in a broader evaluation process, what is normal for each person, considering the way in which the person develops in order to be able to evaluate the present moment. How satisfied she is with her own life, how much she manages to have encounters that generate pleasure and well-being, how much she effectively manages to recognize herself as part of a group or society”, explains Torres.

Signs that may indicate mental health problems