Serbia is at the top of Europe in terms of consumption of anxiolytics, and the corona virus pandemic has led to an additional increase in the use of tranquilizers. Research by Professor Janko Samardžić, Ph.D., specialist in clinical pharmacology and sub-specialist in addictions at the Faculty of Medicine in Belgrade, shows that the consumption of certain sedatives has increased by as much as a quarter compared to 2019, while the consumption of antidepressants has increased by up to ten percent.
In an interview with Politika, Dr. Samardžić points out that, together with his team, he has been monitoring the use of psychiatric drugs in Serbia for ten years, with a focus on anxiolytics and antidepressants. The results of that monitoring show that our country, like other neighboring countries, has a specific situation – very high consumption of anxiolytics (benzodiazepines) and still relatively low consumption of antidepressants, primarily those from the group of serotonin antidepressants. This is also the result of their latest analysis, which testifies that the covid 19 pandemic has led to an additional increase in the use of anxiolytics, while the consumption of antidepressants has slightly increased.
An analysis published in the magazine “Lancet” last year, which dealt with the use of psychotropic drugs in 65 countries of the world, states that Serbia (along with Croatia) is at the top of the world in the use of benzodiazepines. The authors of that analysis state that, although socioeconomic instability is usually taken as an explanation for the high use of benzodiazepines in the Balkans, political and economic turmoil cannot be the only explanation, especially if you look at countries like Jordan and Egypt, which do not have widespread use of these drugs, although they are very politically unstable. When asked how he interprets the fact that Serbia is at the top of the world list for the use of sedatives, Dr. Samardžić says that when analyzing these results, several factors must be taken into account.
– Socioeconomic parameters influence mental health and the use of anxiolytics, however, the prescribing practice by doctors and insufficient control during the dispensing of drugs by pharmacists also has an impact. Finally, I think that in our country tranquilizers are prescribed and used too lightly, while antidepressants are more difficult to accept by patients, due to stigmatization, even though antidepressants are the drugs of choice in the long-term therapy of anxiety disorders – explains our interlocutor.
We ask this expert whether tranquilizers are used more by women or men, younger or older.
– All relevant research, including ours, indicates an increased use of these drugs in women – even twice as many women use sedatives compared to men. Also, anxiolytics are more often used in the elderly, although they are not recommended for elderly patients due to increased trauma, injuries and fractures. Namely, the main side effects of anxiolytics are excessive sedation, confusion, weakened coordination and the development of addiction and tolerance already after a few weeks of use. On the other hand, antidepressants also have their side effects, but a much lower risk of addiction and can be used for a longer period of time, under the supervision of a doctor, of course. In recent years, the number of young people taking tranquilizers has been increasing – as many as 15 percent of students in our research use anxiolytics, which is certainly a worrying figure – notes our interlocutor.
If you keep in mind that all psychiatric drugs are obtained by prescription, what explains such a high use of psychoactive drugs?
– It is true that these drugs are issued by prescription, but we have a problem with prescribing practices among doctors, sometimes under pressure from patients. That is why we recently published a manual for the responsible use of anxiolytics in mental health care, which is intended for all doctors, and I believe that we will have the results of its application in the coming period. On the other hand, we are aware of the problem of dispensing these drugs in pharmacies without a doctor’s prescription, and that is why we need much stricter control – says Dr. Samardžić.
When asked what the comparative European analysis of Serbia and other countries says when it comes to the use of anxiolytics and antidepressants, he adds that Serbia has roughly two and a half times the consumption of anxiolytics compared to the countries of the European Union, while the consumption of antidepressants is twice as low.
– As I mentioned, similar analyzes can be seen in the countries of the region. The results of the consumption of these drugs indirectly indicate the state of mental health of the nation. Therefore, I think that we all need to focus more on mental hygiene in the coming period, because it was particularly neglected during the pandemic. Medicines should be taken critically and responsibly, exclusively under the control of a doctor, and never forget that every medicine has its desired and unwanted effects – concludes Dr. Janko Samardžić.
