Psychiatric medication preferences of sports psychiatrists

When prescribing psychiatric medications to athletes, it is important to consider issues that are especially important for this population, including side effects, safety concerns, and anti-doping policies. Only one report, from 2000, describes the prescribing preferences of psychiatrists who work with athletes. This manuscript aims to update the findings from that report, so as to help inform prescribing practices of primary care physicians, psychiatrists, and other clinicians who work with athletes.

Physician members of the International Society for Sports Psychiatry (ISSP) were sent an email invitation in 2016 to complete an anonymous web-based survey on psychiatric medication prescribing preferences in working with athletes with a variety of mental health conditions.

Forty of 100 (40%) members of the ISSP who identified as physicians and who were emailed the survey ultimately completed it. Top choices of psychiatric medications for athletes across categories assessed included: bupropion for depression without anxiety and without bipolar spectrum disorder; escitalopram for generalized anxiety disorder; melatonin for insomnia; atomoxetine for attention-deficit/hyperactivity disorder; lamotrigine for bipolar spectrum disorders; and aripiprazole for psychotic disorders.

Prescribers of psychiatric medications for athletes tended to favor medications that are relatively more energizing and less likely to cause sedation, weight gain, cardiac side effects, and tremor. Additionally, prescribing preferences for athletes diverged from many of the prescribing trends seen for patients within the general population, in keeping with the assumption that different factors are considered when prescribing for athletes versus for the general population.