New Delhi: Exam pressure, relationship breakdowns, job insecurity and loneliness are bringing people across generations to seek help for their mental health. But as India’s antidepressant and mood-drug market crosses Rs 2,842 crore, a surprising twist emerges: market value is rising even as unit sales decline. Does this signal a growing mental-health crisis, better access to treatment, or a shift in how antidepressants are being prescribed? Doctors say the numbers tell only part of the story.
According to PharmaTrac data, the market grew 8.63 per cent in value to Rs 2,842.1 crore in the 12 months ended September 2026, from Rs 2,616.3 crore in the corresponding period a year earlier. The market has expanded from Rs 1,972.6 crore in September 2022. However, unit sales declined 0.76 per cent in the latest 12-month period.
The divergence between value and volume is significant. While the market is generating higher sales, the decline in units means the increase cannot automatically be interpreted as more patients receiving antidepressants. Further analysis would be needed to establish how much pricing changes or shifts in product mix contributed to the trend.
The product-level data also reveal varying growth rates. Escitalopram combined with Clonazepam remained the largest product in the category, with sales increasing 10.51 per cent to Rs 710.4 crore from Rs 642.9 crore a year earlier. The combination accounted for approximately one-fourth of the market.
Sertraline recorded stronger growth, with sales rising 23.45 per cent to Rs 208.4 crore from Rs 168.8 crore. Desvenlafaxine sales increased 20.45 per cent to Rs 138.7 crore, while duloxetine grew 8 per cent to Rs 210.9 crore. Standalone escitalopram recorded more modest growth of 2.8 per cent to Rs 246.9 crore, while paroxetine sales increased 4.7 per cent to Rs 221.6 crore.
Other products also registered growth. Paroxetine combined with Clonazepam rose 16.9 per cent to Rs 111.5 crore, Mirtazapine increased 11.4 per cent to Rs 101.4 crore, Amitriptyline grew 3 per cent to Rs 123.2 crore, and Flupentixol combined with Melitracen increased 6.6 per cent to Rs 119.6 crore. Fluvoxamine recorded growth of 1.94 per cent to Rs 98.3 crore.
But whether the growth reflects rising illness, improved diagnosis, longer treatment durations or changes in prescribing cannot be established from sales data alone.
Dr Sahil Kohli, Additional Director, Neurology, Fortis Hospital, Gurugram, said the increase in medicine sales could reflect a combination of genuine treatment needs, better recognition and diagnosis, improved adherence, and longer treatment durations or repeat prescriptions.
“Most of the increase appears to be related to genuine treatment needs, better recognition of mental-health conditions, repeat prescriptions and the fact that antidepressants are often continued for an appropriate duration once patients respond to treatment,” he said, adding that more detailed data would be needed to quantify the contribution of each factor.
The distinction between medicine sales and treatment needs is particularly important in a country where a substantial proportion of people with mental-health conditions remain untreated. A 2024 study published in JAMA Psychiatry, examining adults aged 45 years and older in India, estimated the prevalence of depression at 8.6 per cent. It reported that only 1.6 per cent had received treatment, highlighting a substantial gap between the need for care and access to it.
Prescriptions are rising, but the reasons differ
The rise in antidepressant prescriptions is also visible in clinical practice, although individual doctors’ estimates vary and should not be extrapolated to the national population.
Dr Sameer Malhotra, Principal Director, Department of Mental Health and Behavioural Sciences, Max Super Speciality Hospital, Saket, reported an approximately 50 per cent increase in antidepressant prescriptions in his practice over the past three to five years.
He said the concerns prompting patients to seek help vary across age groups. Teenagers commonly present with examination stress, disrupted sleep-wake schedules, excessive mobile-phone use and difficult home environments. Relationship issues and job uncertainty feature prominently among young adults, while marital discord, financial pressures and unhealthy lifestyles affect adults. Among older people, bereavement, loneliness and children settling abroad are important concerns.
Dr Vishal Chhabra, Director of Academics, Adayu Mindfulness, Gurugram, estimated a 10–15 per cent increase in prescriptions in his practice over the same period, with a more pronounced rise among young adults. He clarified that this was a clinical impression, not audited data.
Chhabra said greater openness about mental health had encouraged people to seek help earlier, but cautioned against using pharmaceutical sales as a proxy for disease prevalence.
“Sales data isn’t patient data,” he said, pointing out that market figures do not establish the number of unique patients, their diagnoses, the severity of their conditions or whether prescriptions were clinically appropriate.
The treatment decision itself depends on the nature, severity and duration of symptoms and their impact on daily functioning. Chhabra said counselling alone may help many people with mild depression, while moderate depression may benefit from a combination of medication and counselling. More severe cases may require medication and specialist interventions.
Malhotra stressed that age alone does not determine whether medication is necessary. Patients with clinically significant depression or anxiety need timely assessment and appropriate intervention, which may include medication, counselling, behavioural therapy and supportive care.
The growing clonazepam combination raises questions
The continued dominance of escitalopram-clonazepam is another important feature of the latest market data. The combination’s sales rose 10.51 per cent to Rs 710.4 crore in the year ended September 2026, making it the largest product in the category.
Escitalopram and sertraline are selective serotonin reuptake inhibitors (SSRIs) used to treat depression and certain anxiety disorders. Clonazepam belongs to the benzodiazepine class and can provide faster relief from acute anxiety symptoms.
Kohli said combining the medicines may be clinically useful in selected patients, particularly when anxiety or panic symptoms are severe. Chhabra described clonazepam as a possible short-term bridge while an antidepressant takes effect, with gradual withdrawal under medical supervision once the patient stabilises.
However, Chhabra cautioned against allowing short-term treatment to become routine long-term use. Prolonged benzodiazepine use can carry risks, including tolerance, dependence, sedation and withdrawal-related problems.
The sales figures cannot establish whether the combination is being prescribed for appropriate durations or continued longer than necessary. That would require prescription-level information and clinical follow-up data.
Social media awareness versus self-diagnosis
Social media has made conversations about depression, anxiety and burnout more visible, but it has also created challenges for clinicians dealing with self-diagnosis and misinformation.
Kohli said online content had encouraged awareness and help-seeking, although patients did not commonly approach him requesting a particular antidepressant solely because they had seen it on social media. In his experience, its influence was more apparent in prompting evaluation than in determining the medicine prescribed.
Chhabra offered a more cautionary assessment. In his practice, he estimated that roughly one in five patients arrived through social media, while around one in ten had already self-diagnosed and came with fixed expectations about treatment. These were clinical impressions, not audited data.
“Awareness is welcome; self-treatment is not,” he said, warning that self-diagnosis can delay proper evaluation or lead normal distress to be interpreted as a psychiatric disorder.
Malhotra said excessive internet searches about psychiatric conditions and rare medication side effects could increase confusion and anxiety. Patients sometimes arrive with misconceptions about medicines, making treatment more difficult.
Stopping medication early can complicate treatment
Doctors also point to treatment adherence as an important part of the problem. Chhabra said that, in his experience, more than half of patients stop treatment earlier than recommended. Some discontinue medicines when they begin to feel better, while others worry about side effects or dependence.
Malhotra warned that stopping antidepressants, reducing doses or changing medication on the basis of social-media posts or online-community advice could make treatment more difficult and increase the risk of relapse or recurrence. He did not provide an estimate of the proportion of patients who do so.
Doctors emphasise that antidepressants should not be started, stopped or altered without consulting the treating clinician. Treatment duration and any reduction in dosage need to be decided individually, with medical supervision.
Chhabra also highlighted the role of general physicians in identifying common mental-health conditions and initiating appropriate treatment. What matters, he said, is ensuring patients receive a proper assessment, understand the recommended treatment duration and are referred for psychiatric supervision when necessary.
Measuring progress beyond sales
For Malhotra, the more meaningful indicator of India’s mental-health progress is the treatment gap: the proportion of people who need mental-health care but do not receive it. He said medicine sales cannot show whether patients are improving or whether vulnerable and economically disadvantaged populations are being left behind.
Chhabra suggested tracking suicide rates alongside access to treatment and antidepressant use to assess whether care is translating into better outcomes. Sales figures alone cannot establish whether people are recovering.
The latest PharmaTrac data underline the need to distinguish market growth from treatment outcomes. An 8.63 per cent rise in market value alongside a 0.76 per cent decline in unit sales does not, by itself, establish whether more people are receiving care or whether prescribing practices have changed.
For India, the larger question is whether people who need treatment are being identified early, prescribed appropriate medication where necessary, supported through the recommended course of treatment and followed up to assess outcomes. Until those measures are tracked alongside sales, a growing antidepressant market will remain an incomplete indicator of the country’s mental-health progress.
