Portugal Dispenses 80,000 Psychotropic Packages a Day as 2025 SNS Spend Hits €152 Million — Infarmed Data Show Antidepressant Use Up 82% in a Decade

Portuguese pharmacies dispensed almost 29.4 million packages of psychotropic medication in 2025 — around 80,000 packages every day — and the Serviço Nacional de Saúde paid roughly €152 million of the bill, according to fresh data from the Autoridade Nacional do Medicamento (Infarmed) reported on 23 April. Both the volume and the public cost are the highest on record, and the decade-long trajectory is steeper than almost any comparable European country.

Between January 2015 and December 2025, the total number of psychotropic packages sold in pharmacies in mainland Portugal rose from 21.6 million to 29.4 million — a 36% increase. SNS outlays on the same basket went from €123.1 million to €156.6 million (+24%), with the €152 million headline in the latest Infarmed release covering only the state-reimbursed slice of that total. The pattern, in other words, is growth everywhere, tempered only by the state's negotiating power on reimbursement prices.

Antidepressants are the single biggest driver

The sharpest line in the Infarmed series is for antidepressants. Packages rose from 7.6 million to 13.8 million over the decade — up 82% — and public expenditure on the class ballooned from €33.7 million to €63.6 million, a +89% swing. That makes antidepressants the fastest-growing reimbursed drug class in Portugal in volume terms, outpacing even the GLP-1 agonists that dominate the diabetes-and-obesity debate.

Antipsychotic use has also climbed, although in a more contained pattern. Packages went from 3.2 million to 5.5 million (+72%), but SNS expenditure actually fell 4.5% to €65.7 million — a function of generics entering the market and existing reference prices being cut under Infarmed's periodic reviews. Anxiolytics and hypnotics remain the heaviest-used sub-classes per capita, with Portugal still carrying the highest benzodiazepine consumption rate in the European Union, a feature that pre-dates the pandemic and that successive health ministers have flagged as a clinical-practice concern.

More prescribing, or more treating?

Clinical opinion on what the numbers mean is mixed. Psychiatrist Ana Matos Pires, past president of the Portuguese Psychiatric Society, told Público that rising prescribing rates are "always an indicator" that there may be more people in distress — but also that the system is "diagnosing and treating serious mental illness more promptly". The latter interpretation lines up with the roll-out of the Plano Nacional de Saúde Mental 2017-2024, which explicitly targeted earlier pharmacological intervention for severe depression and psychotic disorders, and with the expansion of GP training in basic mental-health prescribing.

Less encouraging is the persistent gap on non-pharmacological treatment. Specialist groups point out that access to structured psychotherapy through the SNS remains rationed by long waiting lists: in many regional health administrations the average wait for a first outpatient session exceeds six months, and Portugal has one of the lowest numbers of clinical psychologists per capita among EU-15 countries. The result is a system that can prescribe an SSRI within a week, but often cannot offer talk therapy to go with it.

What expats should take from this

For foreign residents using the SNS, the practical implications are mixed. Access to antidepressant and antipsychotic medication through an ordinary médico de família appointment is straightforward and heavily subsidised, with most common molecules reimbursed at 37-69% of list price. Access to publicly funded psychotherapy, by contrast, is materially harder — and many expats eventually pay out-of-pocket through the private sector or their employer health plan, where a standard session runs €60-€90 in Lisbon and Porto.

The political follow-through is worth watching. Parliament is due to debate the 2027 budget preparation in Q3 2026, and the Bloco de Esquerda has already flagged an amendment tying new SNS mental-health funding to an expansion of clinical-psychologist posts — a proposal that will now land in a committee room with Infarmed's 80,000-packages-a-day number fresh on the table.