REF-1659 · Reardon & Factor, 2010 · Sports Medicine, · Paper · PubMed

In 2010 there were no large, systematic studies of psychiatric medication in athletes: a sport-psychiatry review found only small studies, some suggesting a drug helped performance and others that it hurt, too flawed for firm conclusions, and called for longer studies in athletes who actually have the disorder, with both sexes represented

Main caveat: The abstract shows no search or appraisal method; graded as a narrative review until the full text shows otherwise.
thin evidenceMeasured on a mixed groupRead from the abstract only

Reardon and Factor reviewed what had been published on diagnosing psychiatric illness in athletes and treating it with medication, noting that clinicians often care for athletes without knowing the diagnostic and treatment issues particular to them.

Prevalence had been studied for some disorders; eating disorders and substance abuse were the most studied and appeared common in athletes. Overtraining syndrome, bipolar disorder, suicidality, anxiety disorders, ADHD and psychosis in athletes needed much more work on prevalence, risk factors, prognosis and athletes' experience.

No large, systematic study of psychotropic medication in athletes existed. Small studies hinted that some drugs might improve and others impair performance, but their methods did not allow firm conclusions. Athletes at higher levels with psychiatric symptoms often hesitated to take drugs whose effects on performance and safety were unknown.

The authors call for more and better studies of antidepressants, mood stabilisers, anxiolytics, stimulants and other ADHD drugs, sedative-hypnotics and antipsychotics, using sensitive performance measures and longer-term use, in athletes who have the disorder being treated, and with more women.

Participants

No participants of its own. The populations of the studies reviewed (sports, levels, sex, numbers) are not in the abstract; PubMed indexes both sexes.

Methods

Described in the abstract only as a systematic review of published findings on psychiatric diagnosis and medical treatment in athletes.
Databases, dates, search terms, inclusion rules, number of studies and any quality appraisal: not in the abstract.

Key Results

Eating disorders and substance abuse were the most studied disorders in athletes and appeared to be common problems.
Little research on overtraining syndrome, bipolar disorder, suicidality, anxiety disorders, ADHD and psychosis in athletes.
No large, systematic studies of psychotropic medication in athletes; small studies suggest some drugs may enhance and some may impair performance.
Methodological problems in the existing studies preclude definitive conclusions on performance effects.
Higher-level athletes with psychiatric symptoms often have reservations about drugs with unknown performance and safety effects.
Asked for: sensitive performance measures, longer-term use, participants who have the disorder, and more women.
No numbers are given in the abstract.

Practical Application

How psychiatric drugs affect training was barely studied, so the choice of drug and dose belongs to the prescriber, who can weigh the athlete's sport. In 2010 there were no large studies of these drugs in athletes, and the small ones pointed both ways.
Hesitancy is common and worth saying out loud to the prescriber. The authors note that higher-level athletes often hold back from drugs with unknown performance effects; an athlete with that worry should raise it with the prescriber rather than stop or skip a drug on their own.
The prescriber decides. Starting, stopping, switching or dosing a psychiatric medication is for the prescribing doctor or psychiatrist; the assistant does not diagnose or change medication, and for symptoms the route is a doctor, psychiatrist or psychologist (REF-633).
Not from this paper: the size or direction of any single drug's effect on performance; for antidepressants, the later meta-analysis in REF-1656 gives numbers.

Limitations

The abstract shows no search or appraisal method; graded as a narrative review until the full text shows otherwise.
No numbers, drug names or study sizes in the abstract.
Published in 2010; newer studies are not covered.
Written from the abstract and the PubMed record; full text not read.
How this entry was checked and changed
Why this level

graded as a narrative review (rule 5) because the abstract shows no systematic method; even with one shown, a review of prevalence studies and small drug studies read from the abstract would be capped at B+

Content correction 2026-11-07
2026-11-07: added from the abstract and the PubMed record; level C+ (self-described systematic review with no method shown in the abstract; graded as a narrative review).