Attention deficit hyperactivity disorder in sport: a review

Attention deficit hyperactivity disorder (ADHD) is a controversial problem in sport since participants with this disorder often require banned stimulant medication while competing. Little information is available in the literature concerning this problem or whether sports people should be allowed to participate while on stimulant therapy. The intention of this review is to undertake a brief review of recent findings in ADHD, especially as they apply to sport, and suggest some guidelines that could then be applied by sporting bodies to allow ADHD sufferers to compete. Recent scientific evidence, clinical, genetic, and imaging techniques, confirm that ADHD is characterised by dysfunction in dopamine transmission in the frontal lobes and basal ganglia structures, regions associated with attention and behaviour. The dopamine transporter (DAT) regulates dopamine by removing excess. In ADHD people, the number and density of DATs and DAT binding sites are increased by up to 70 %. The dopamine agonist methylphenidate blockades DAT, significantly increasing extra cellular dopamine, so correcting the dopamine deficiency. Methods. A search of the English literature was made using Medline from the years 1980 to 2002. [nl]The aim of this review is not to debate the use of stimulants or how often they are necessary or successful in this condition but to point out that a number of young sport people with ADHD require such medication on a regular basis. Although there are problems with their use as far as the International Olympics Committee (IOC) is concerned, it would seem most unfair to penalise sports people by having to give up their medication, even for a few days or at some arbitrary age, in order to compete.