ADHD Medication and Sports: Is There an Advantage? by Dr. Sharon Orrange/Primary Care Physician: at DailyStrength Doctors and Advisors

Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…

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Assistant Professor of Clinical Medicine, Division of Geriatric, Hospital and General Internal Medicine, Keck School of Medicine, University of Southern California

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ADHD Medication and Sports: Is There an Advantage?

Posted in ADHD / ADD by Dr. Sharon Orrange on Aug 30, 2011

In most students with ADHD, motor function is unimpaired and sports are an outlet for their need to be active. Most children with ADHD do not have motor coordination problems, and have more positive interaction around sport than academics. It has been shown that sport participation may improve function in children with ADHD. For children with ADHD, involvement in sports can improve their lives far beyond the playing field and sports can become a haven from the negative feedback they receive in other situations.

So, what is the effect of ADHD on sports and may it offer an advantage in some sport activities? Many exceptional athletes have ADHD and, in some circumstances, ADHD may offer advantages. Impulsivity may equate with spontaneity and quick decision making. Examples given in the literature include basketball point guards who are good playmakers and football quarterbacks who have the ability to make a play instantly (impulsively) without reflection. Many athletes with ADHD report the ability to hyper focus on enjoyable activities, block out distractions and focus on the competitive event. Michael Phelps, the multiple Olympic gold medal winning swimmer, has ADHD and a legendary ability to focus.

What about ADHD medications and sports? Many college athletes are on medications for ADHD. In the 2009 to 2010 academic year, Texas A&M University had 701 total NCAA athletes and fifty of these athletes were taking stimulant medication for ADHD.

What is the effect of ADHD medication on sports activity? Significant increases in knee extension strength, acceleration, time to exhaustion during exercise and pre-exercise and maximum heart rates have been shown after administration of 15 mg of dextroamphetamine versus placebo. Studies done on athletes on stimulant medications have showed enhanced performance in warm conditions where players produced greater power output and had higher core temperatures without the perception of increased effort or thermal stress. The downside of this is that stimulants may potentially increase the risk of developing heat illness during exercise in individuals taking them. Recent reports of increased heat related deaths in college athletes should raise the question of whether ADHD medications are contributing. Athletic trainers and coaches need to know which athlete is taking ADHD medications and watch them more carefully for heat illness.

What about the heart and athletes taking ADHD Medications? There is no greater risk of sudden cardiac death in patients taking stimulants for ADHD than in those without ADHD not taking stimulants. The risk that does exist is that of sudden cardiac death in athletes taking ADHD medications who have underlying structural heart disease. A careful history and physical examination should be done in all athletes on ADHD medications and a follow up EKG and cardiology referral only in those with significant abnormalities on the history and physical.

The NCAA allows for stimulant use by athletes with adequate documentation of diagnosis of ADHD and evidence of continued follow-up, and the drug may be present at the time of competition.

Thoughts?

- Dr O.