From battlefield to pharmacy: Why Russians are turning to antidepressants at record levels after four years of war

Russian Sukhoi SU-25 fighter jets fly above Moscow during the general rehearsal of the Victory Day military parade on May 7, 2025. Russia will celebrate the 80th anniversary of the Soviet Union's victory over Nazi Germany in World War Two (WWII) on May 9. (Photo by TATYANA MAKEYEVA / AFP)

Antidepressant sales in Russia have surged to record highs amid the war with Ukraine, economic decline, and political repression. The rise reflects growing mental health strain, with access to medication worsening, especially outside major cities.

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Nearly four years into the war with Ukraine, Russia is facing a quieter crisis that rarely features in official speeches or battlefield updates. Russians are consuming antidepressants at levels never seen before, pointing to a growing mental health burden driven by war, economic stress, and political repression.

Market data, industry research, and reporting by The Telegraph show that antidepressant use has risen steadily since the Covid-19 pandemic and surged sharply after the invasion of Ukraine. The trend now far exceeds levels recorded during earlier national crises.

Antidepressant sales at record highs

According to market research by Russian consultancy DSM, pharmacies sold 8.4 million packages of antidepressants in 2019. That figure rose to 13 million in 2022, then climbed to 15.3 million in 2023 and 17.9 million in 2024.

By 2025, annual sales reached 22.3 million packages, nearly three times pre-pandemic levels. DSM data also show that antidepressant sales grew by 36 percent in 2025 alone, a rate far higher than in previous years.

Another consultancy, RNC Pharma, estimated that sales may be even higher, placing the total at 23.5 million packages.

Between January and October 2025, pharmacies sold 19.1 million packages. Retail turnover peaked in October at 15.7 billion rubles, the highest monthly figure ever recorded for antidepressants in Russia.

Moscow and the surrounding Moscow Oblast accounted for 31 percent of sales by value, highlighting the pressure felt in major urban centres where political control, economic strain, and social change are most intense.

War stress outweighs the pandemic

The scale of the increase stands out when compared with earlier crises. During the first year of the Covid-19 pandemic, pharmacies sold 7.9 million packages of antidepressants. In 2021, sales rose modestly to 9.2 million.

Those figures now appear low compared with post-2022 levels. Analysts say the steady rise since the war began points to a deeper and more sustained psychological impact than the pandemic.

Thousands of Russians have been detained for opposing the war. According to figures cited by The Telegraph, more than 20,000 people were arrested for anti-war activity between 2022 and last year.

Stanislav Stanskikh, a Russia expert, linked antidepressant use to these pressures. Speaking to The Telegraph, he said, “The increase is attributed to reduced stigma around seeking mental health care, stockpiling amid sanctions, and broader economic and social shocks.”

He added, “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.”

Living under fear and uncertainty

Stanskikh also pointed to the wider social climate 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,” he said.

“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.”

Polling data support this picture. More than one-third of Russians now believe the national economy is worsening, up 10 percentage points from 2022. Nearly half say it is a bad time to look for work, while close to one-third report difficulty affording food.

Economic strain adds to mental pressure

Sanctions, trade disruption, and higher military spending have reshaped household finances. Funding for welfare, pensions, and education has been redirected towards sustaining the war effort, according to multiple reports.

Food prices have become a visible symbol of hardship. Since 2024, the price of potatoes has risen by 167 percent following poor harvests, according to Russian media. For many households, potatoes are a staple, making price increases especially painful.

Income disparities remain sharp. As of January 2025, the average monthly salary stood at about $908. In Moscow, incomes averaged around $1,150 annually. In contrast, military recruits can earn over $2,583 per month, plus bonuses and compensation tied directly to war service.

Human cost of the war

Independent counts by Mediazona in collaboration with the BBC confirm that more than 160,000 Russian soldiers had been killed by the end of 2025. Analysts believe the real number is far higher, with estimates of total losses reaching over 350,000 when wounded and unreported deaths are included.

These figures do not capture the psychological trauma faced by returning soldiers, families, and communities affected by repeated mobilisation.

What Russians are buying and what they cannot find

Antidepressants now rank second in Russia’s retail pharmaceutical market by value. The most commonly sold drugs include sertraline, fluoxetine, and amitriptyline. Zoloft is the highest-selling medication in the country.

Ironically, many of these drugs are Western-developed SSRIs such as Zoloft, Prozac, and Cipralex, despite state rhetoric critical of the West.

At the same time, access is becoming harder. Complaints about missing medicines rose to 22,700 in the first nine months of 2025, up from 19,100 in the same period in 2024. More than 63 percent of complaints involved drugs unavailable on shelves.

Russia also lost 754 pharmacies between January and September 2025. Smaller towns and rural areas are especially affected, forcing residents to travel farther for basic medicines.

While antidepressants remain relatively cheap by Western standards, income gaps mean affordability varies widely outside major cities.

A silent crisis

Russia’s antidepressant surge reflects more than better awareness of mental health. It mirrors the emotional cost of a long war, economic decline, political repression, and social isolation.

Unlike the pandemic, the war is not an invisible threat. Its impact is felt through casualties, arrests, rising prices, and shrinking opportunities. The growing reliance on antidepressants offers a rare, measurable glimpse into how deeply these pressures are affecting everyday life in Russia.