ADHD Medication, Exercise and Elite Sports

Navigating between ADHD medication and intense exercise can be complex, especially for elite athletes. ADHD medications can enhance performance. But it also has side effects, like increased heart rate and blood pressure. This article explores whether to maintain or take a break from medication during training and competitions.

Do you use physical activity as one of your strategies to manage your ADHD symptoms? Perhaps your need for constant movement, stimulation and competitive instinct has even led you to become a professional athlete. But how do ADHD medications and intense physical activity actually work together? 

Should you avoid medications when training intensely or during competitions? Or is it okay to continue with the same dose you use daily?

It’s time for the Olympic Games in Paris, so what better time to dive into what the research says? A large study summarized the research on ADHD medications and physical and elite sports a few years ago, revealing the following:

1. Performance Enhancement:

   • Central stimulant ADHD medications like methylphenidate and dexamfetamine generally have a performance-enhancing effect. Particularly concerning explosiveness, endurance and performance capacity.

2. Physical Effects:

   • ADHD medications affect the body by increasing heart rate and body temperature. Even during physical activity.

   • No severe adverse health effects or incidents have been reported for elite athletes taking ADHD medications as prescribed by a doctor.

3. Contradictory Results:

   • The results of the meta-analysis were somewhat contradictory. For example, methylphenidate showed clear positive effects on power output but negative effects on longer-term performance.

   • The study emphasized that many included studies were limited by small sample sizes, differences in study design and challenges in generalizing results to other groups than those studied.

In summary, ADHD medications can improve certain aspects of physical performance. However, their impact on various physiological parameters is complex and not fully understood.

Can Raise Heart Rates

A well-known side effect of stimulant ADHD medications is that they increase pulse and blood pressure. This increase in heart rate and blood pressure also applies to elite athletes. People that often have lower pulse and blood pressure due to their good physical condition compared to untrained individuals. 

“…increase in heart rate and blood pressure”

When starting stimulant medications, it’s common to experience an increase in both heart rate and blood pressure. This is due to the medication’s stimulating effects on the central nervous system. 

For some, the body can adapt to the medication over time, reducing the pulse increase. In contrast, others may continue to experience an elevated heart rate as long as they take the medication. 

“Therefore, it is important to monitor your values according to your care plan.”

If a significantly elevated heart rate persists and poses a health risk, it may be necessary to adjust the dose or consider trying another treatment.

Skipping Meds for Competitions

Some athletes choose to take a break from the medication during training or competitions. Since the competition itself often means they don’t need their ADHD medication to focus and function. 

Some feel that the stress of competition becomes too much if they also add the stress from ADHD medication. Therefore they choose not to take meds on competition days. 

For methylphenidate, the effect usually wears off overnight. While for lisdexamfetamine, it can take 1-2 days for all medication to leave the body. However, the most significant effect is likely gone the day after skipping the medication even for lisdexamfetamine.

As a competitive and elite athlete, it’s also:

important to ensure that you follow the rules for allowed and banned substances.

That may require reporting the use of stimulant medications. Some organizations have specific rules regarding the use of ADHD medications in competition contexts.

In summary

• The increase in heart rate due to stimulant medications can normalize over time for some individuals, but it is not guaranteed for all.

• Some choose to discontinue medication before competitions, with the largest amount of the drug leaving the body after 24 hours. However, some medications can show up in tests for up to a few days after discontinuation.

• Athletes should consider regulatory guidelines and the potential impact on performance when deciding on medication use during training and competitions.

For exact recommendations and guidelines, it’s always best to consult a healthcare professional specializing in sports medicine. Someone familiar with your medical history and the specific requirements of your sport.

If you want to know more about ADHD and training, have a go at these articles: “Move more, live better” and “Just do it!”.

Best of luck to all (Olympic) athletes!

Reference:
Berezanskaya J, Cade W, Best TM, Paultre K, Kienstra C. ADHD Prescription Medications and Their Effect on Athletic Performance: A Systematic Review and Meta-analysis. Sports Med Open. 2022 Jan 13;8(1):5. doi: 10.1186/s40798-021-00374-y. PMID: 35022919; PMCID: PMC8755863.

Lotta Borg Skoglund

MD PhD & Letterlife Co-founder

Latest posts