Athletes and Psychiatric Medications

Psychiatric medications can be very helpful for treatment of mental illness for many people, including athletes. However, while any decision to use psychiatric medications involves careful consideration of a number of factors, athletes must often consider additional factors such as potential effects of medications on athletic performance, medication safety, and anti-doping guidelines.   

Consider these tips if you or an athlete you know is considering use of a psychiatric medication. 

Potential side effects  Many athletes want to avoid medication side effects that might impair performance.  Especially troubling side effects for athletes include sleepiness, dizziness, abnormal heart rhythms, nausea, tremor, and weight gain.  Risks and benefits must be weighed when an athlete is considering taking a psychiatric medication.  Even if the medication causes side effects, this might be better than continuing to suffer with psychiatric symptoms, which can also interfere with performance. 

Medications

Antidepressants:  A survey of sport psychiatrists showed that one of the most widely used antidepressants in athletes is fluoxetine (Prozac), probably because it does not cause sleepiness or weight gain and might be somewhat activating.  Other antidepressants similar to fluoxetine include sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).  Bupropion (Wellbutrin) is another antidepressant that does not seem to impair performance or cause sleepiness or weight gain.  One antidepressant, paroxetine (Paxil), is less likely to be used in athletes because it can cause sleepiness and weight gain.   

Mood stabilizers:  Strenuous exercise may cause levels of lithium, the medication most commonly used to treat bipolar disorder, to become too high or too low.  Also, athletes taking lithium should not take anti-inflammatories such as ibuprofen. 

Anxiety medicines:  Most sport psychiatrists favor buspirone (Buspar) rather than benzodiazepines (such as lorazepam and alprazolam) for anxiety in athletes.  Benzodiazepines can cause sleepiness and problems with coordination and balance.     

Banned substances:  There are anti-doping prohibitions against certain medications for athletes at the college and elite levels, but bans do not usually exist at lower levels of competition.  The NCAA has recently revised its policy on medication use sports.  

For more information: 

NCAA Drug Testing Program  

American Academy of Child and Adolescent Psychiatry 

National Alliance on Mentally Illness
Information Helpline: 800-950-NAMI (6264)