Treatment of ADHD in athletes. Behavioral therapy can be used as an alternative to or in combination with stimulants to manage ADHD, and the authors note that a combination of different modalities are generally used to manage ADHD symptoms in athletes.

Behavioral therapy can be used as an alternative to or in combination with stimulants to manage ADHD, and the authors note that a combination of different modalities are generally used to manage ADHD symptoms in athletes.

Stimulant medications remain the first-line treatment for managing ADHD symptoms, although their use in athletes with ADHD is controversial owing to their performance-enhancing capabilities and potentially harmful side effects. For example, the thermo genic effects of stimulant medications may be elevated during physical activity, such that athletes prescribed
stimulants may be at risk of heat injury or cardiac arrhythmia. However, some stimulants are permitted at elite-level sport, if the athlete has diagnosed ADHD and has obtained therapeutic use exemption documentation.

Several studies have demonstrated a link between aerobic exercise and improved cognitive and behavioral function (Berwid, Halperin 2012), and the authors suggest that a structured programme of physical activity should be considered as a non-pharmacological treatment option for ADHD.


  • Medication :

Athletes with ADHD can continue using necessary prohibited stimulant medications while competing in sanctioned sports as long as they receive a Therapeutic Use Exemption (TUE), which requires them to demonstrate that they can satisfy strict criteria for TUE approval.


  • Athletes with ADHD :

With sports stars like Terry Bradshaw and Pete Rose leading the way, these rising athletes have stepped forward to share their personal journeys with ADHD. An NBA player and an Olympic women’s hockey medalist have transformed symptoms into assets. Michael Phelps is not alone. Many experts say a connection between ADHD and athletics makes sense. “Having ADD can actually be an advantage in certain sports for ADHD children,” says Mike Stabeno, author of The
ADHD Affected Athlete.

“While some activities require intense concentration, that’s not always the case with athletics. Everything happens instantaneously. You’re in there for 10 minutes, you’ve got five people trying to take your head off, three referees, four teammates. You need to take in everything that’s going on all at once. That’s how people with ADD go through life. So it
makes sense that they thrive in this field.”


  • Impact of ADHD on athletes :

The prevalence of ADHD among athletes is unknown, although, as reported by Kaufman (2011), ADHD prevalence may be higher among collegiate and professional athletes compared with the general population. The authors suggest that this may be due to the beneficial effects upon ADHD symptoms of physical exercise and positive reinforcement associated with team-
based sports. However, the sample size used in the 2011 study was small (n = 7), and further
investigation is required.

ADHD symptoms are often first identified by parents and teachers. In some cases, disruptive behaviour and poor academic performance may be excused if the student is a high-performing athlete, resulting in late diagnosis of ADHD. Physicians treating collegiate athletes should be aware of ADHD symptoms, as symptoms are often unmasked in later educational settings by higher academic demands and a greater requirement for independent functioning.

ADHD negatively impacted strength, agility and coordination in children (Cho et al. 2014),which may in turn have an impact on social functioning and participation in sports; however, the effects of pharmacological treatment on motor functioning in children with ADHD are understudied.

The impact of ADHD on athletes and the effects of participation in athletic activities upon ADHD symptoms share a complex relationship. Participation in sport demands attentiveness, organisational skills and conforming to a structure, but many parents/coaches have reported positive effects of sport participation on ADHD symptoms. Additionally, potential side effects of stimulants used to treat ADHD may be exacerbated by exercise and/or high-stress environments.


The authors concluded that athletes with ADHD should be monitored by knowledgeable
practitioners with an awareness of the side effects of prescribed medications and their relevance
to physical activity, as well as knowledge of the regulatory guidelines of an athlete’s chosen
sport.