Objectives
Stressful events can impact the incidence of psychiatric disorders and, therefore, psychiatric drug use. However, it is not clear whether psychiatric drug use is stable or not across the Brazilian population over time. The aim of this study was to investigate trends in psychiatric drug sales in Brazil over the years, using sales data from private-sector pharmacies as a proxy for psychiatric drug consumption.

Methods
This is a non-interventional pharmacoepidemiological study using routinely collected health data from 2015 to 2021. The primary outcome was the amount of psychiatric drugs sold, corresponding to an individual or entity purchase recorded in the national system. 

Results
We found an overall annual increase in psychiatric drug sales in the last few years (Z = -2748·7, p = 2·2 x 10-16). Antidepressants and antipsychotics are by far the top seller psychiatric drugs. The south and southeast regions of Brazil and the state of Pará simultaneously show high levels of psychiatric drug sales, COVID-19 confirmed cases, and per capita income. We have raised hypotheses that might help explain the variations in psychiatric drug consumption. We provide evidence of a growing psychiatric drug sale over the years, likely reflecting an increase in psychiatric disorders or symptoms. 

Conclusion
The trend reported here indicates an association between increased psychiatric drug sales and recent socioeconomic and health crises, including the COVID-19 pandemic, but causality cannot be established. This is possibly just the beginning of a major nationwide challenge that deserves attention going forward so that effective measures are implemented.