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New therapeutic approaches offer an approach to mental health with fewer stigmas
Santo Domingo. – More than a billion people worldwide live with mental health disorders, according to recent data from the World Health Organization (WHO). Conditions such as depression, Attention Deficit Hyperactivity Disorder, bipolar disorder and schizophrenia, among other pathologies, constitute one of the main causes of health loss in the world, moving from ninth to sixth place by 2021, according to the Institute for Health Metrics and Evaluation (IHME), increasing the costs of care for those affected and their families, while generating significant economic losses on a global scale.
In Latin America and the Caribbean, the burden of mental disorders before the COVID-19 pandemic was already significant and was continuously increasing over time. As of 2021, an average of 15,000 cases were recorded per 100,000 inhabitants, considering 20 countries in Latin America and the Caribbean, with access to health care being one of the main obstacles to addressing this problem, since mental health services are scarce throughout the region, and even when a diagnosis is achieved, access to treatment is not guaranteed. According to the IHME, in the Dominican Republic the prevalence of mental disorders is 15,505 cases per 100,000 inhabitants.
According to the Pan American Health Organization (PAHO), between 75–90% of people with mental, neurological, and substance use disorders (TMNS) in Latin America and the Caribbean do not receive the necessary treatment, despite the existence of approved effective treatment.
In the case of schizophrenia, the attention gap reaches 72% and in depression and anxiety, it exceeds 80%, which demonstrates the low investment that countries still maintain when it comes to mental health, allocating on average only 2% of the health budget to this area in the region.
While investment in mental health remains minimal in the region, science has made remarkable advances that are transforming the treatment and lives of patients, allowing for better management of their pathologies and also greater social integration, reducing the stigma associated with mental disorders.
This is the case with third-generation antipsychotics, which have shown significant improvements in quality of life, greater tolerance, and better social functioning in patients with schizophrenia, bipolar disorder, and major depression. These treatments work by balancing the dopamine signal, with a “modulator” mechanism —neither total blockage nor excessive stimulation— that allows control of positive symptoms and, in certain cases, also negative and affective symptoms with good tolerability.
Additionally, these therapies generate a lower record of adverse events perceived by patients, such as less sensation of sedation and reduction in metabolic impact, which improves adherence and quality of life, thereby reducing the stigma associated with antipsychotic therapies, increasing their insertion in work, educational and family environments.
“Third-generation antipsychotics represent a significant advance: they offer a better tolerance profile, less metabolic impact, and a procognitive effect that allows patients to maintain their emotional, social, and work functionality. This is a paradigm shift regarding the approach to mental health, as these treatments allow the patient to be treated without ‘nullifying’ them, favor deinstitutionalization, and align with the new mental health care models that promote social reintegration,” says Anna Patricia Alessandría, Medical Manager of Psychiatry at ADIUM Central America and the Caribbean.
And it adds that these third-generation antipsychotics help regulate the mood, behavior, and thoughts of patients with schizophrenia, with acute or mixed manic episodes associated with Bipolar I Disorder in adults, with depressive episodes associated with Bipolar I Disorder, or with complementary therapy to antidepressants for the treatment of Major Depression (MDD).
Innovation in therapeutic treatments focused on mental health is generating benefits ranging from improved memory, reduction of affective symptoms in depressive phases to an increase in motivation and social participation; therefore, it is important to strengthen mental health care in this regard, to reduce treatment gaps in the region.
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