Portugal's psychotropic drug use soars 36% in a decade, straining health budgets

Mental health specialists attribute the rise in psychotropic drug use to several factors, including increased diagnosis and broader access to treatment, the gradual replacement of benzodiazepines with antidepressants and antipsychotics, as well as demographic shifts such as a growing resident and tourist population and persistent difficulties in accessing psychotherapy.

The data cover prescribed and subsidized medications dispensed in community pharmacies between January 2015 and December 2025. During this period, the number of psychotropic drug packages rose from 21.6 million to approximately 29.4 million—a 36% increase.

This surge has placed a heavier financial burden on Portugal's National Health Service (SNS), with costs climbing from €123.1 million to €156.6 million—a 24% rise.

More Cases or Earlier Diagnosis?

Antidepressants saw the sharpest growth, with packages increasing from around 7.6 million to nearly 13.8 million—an 82% jump. Associated spending rose from €33.7 million to €63.6 million, up 89%.

Antipsychotics, primarily used to treat conditions such as schizophrenia and bipolar disorder, also saw a rise in consumption, from roughly 3.2 million to 5.5 million packages—a 72% increase. However, public spending on these drugs fell from €68.8 million to €65.7 million, a 4.5% decrease.

In contrast, benzodiazepine prescriptions declined, dropping from about 10.8 million to 10.1 million packages—a 6.9% reduction. Despite this decrease in usage, costs rose from €20.6 million to €23.4 million, a 13.5% increase.

Commenting on the figures, psychiatrist Ana Matos Pires, coordinator of the National Mental Health Policy, noted that the rise in psychotropic prescriptions "is always an indicator" that more people may be suffering, but it also suggests that serious mental illness is being diagnosed and treated earlier.

"Of course, it's never good for serious mental illness to exist, but it's far worse for it to go untreated," she emphasized, adding that antidepressants are not limited to depression. They are also prescribed for severe anxiety, obsessive-compulsive disorder, and chronic pain.

Pires highlighted the decline in benzodiazepine prescriptions as "good news," given their risk of dependence. "These figures reassure me because what was—and remains—a major public health concern, the overprescription of benzodiazepines, is decreasing," she said.

She also believes the data reflect greater awareness of serious mental illness and earlier help-seeking behavior, linked to reforms in mental health services and the expansion of community-based teams that "reach people more quickly."

Tourism and Population Growth May Play a Role

Albino Oliveira-Maia, president-elect of the Portuguese Society of Psychiatry and Mental Health, argued that the data should be analyzed in the context of demographic changes and inflation.

A psychiatrist and director of the Neuropsychiatry Unit at the Champalimaud Foundation, Oliveira-Maia noted that with more residents and tourists, demand for healthcare—including psychotropic medications—is naturally rising.

He also suggested that some of the increase may stem from therapeutic substitutions, particularly the reduced use of benzodiazepines. "There is a growing trend to avoid these drugs," he explained, noting that certain antidepressants and antipsychotics can be prescribed in low doses to treat insomnia.

While Oliveira-Maia acknowledged that the data may indicate improved access to mental healthcare, he cautioned that "despite progress, we are still far from the desired levels."

"Access to other treatments, such as psychotherapy, remains relatively difficult, both within and outside the National Health Service," he lamented.

Miguel Ricou, president of the Clinical Psychology and Health Specialty Council of the Portuguese Psychologists Association, also called for greater investment in psychotherapy.

"The rise [in consumption] clearly shows the difficulty in accessing alternative mental health interventions," he said, as well as the challenges in seeing psychologists and psychiatrists. This often leads family doctors to prescribe psychotropic medication as a first-line response.

"Without rapid access, a cycle of medication and relapse develops that is hard to break," he warned.