prescription medicines, Sport performance

Elite athletes use prescription medicines more than twice as often as non-athletes, putting them at risk of a range of side effects that could adversely affect their sport performance. That’s the worrying conclusion of a new study from Finland – the first to compare medicine use in a large number of Olympic-level athletes with that in the general population.

A structured questionnaire asking about use of prescribed medicines was completed by 446 of the 494 athletes financially supported by the Finnish National Olympic Committee and an age-matched sample from the general population.

Analysis of the results showed that the athletes used four types of medication significantly more than the controls. These were:

• Anti-allergic medicines, used by 12.6% of the athletes during the previous seven days, compared with 6% of controls;
• Non-steroidal anti-inflammatory drugs (NSAIDs), used by 8.1% v 2.7%;
• Anti-asthmatic medicines (7% v 2.3%);
• Oral antibiotics (2.7% v 1.3%).

Speed, power and endurance athletes used more medications than athletes in skill-based events and team sports, with speed and power athletes being particularly heavy users of NSAIDs (18.6%) and endurance athletes of anti-allergic medications (19.4%). Of particularly concern to the researchers was the fact that one in every five athletes using NSAIDs – particularly those using the acetic acid derivatives indomethacin and diclofenac – reported drug-related side effects.

The researchers comment: ‘Many athletes with minor injuries do not take enough time off training or competition to allow proper healing. Instead of temporary immobilisation and local cryotherapy, they begin to treat their problems with NSAIDs and continue exercising… Few physicians and patients question their efficacy or consider their potential adverse effects or systemic toxicity.’

Yet, as they point out, changes in renal function and even renal damage have been reported in athletes taking NSAIDs during exercise. This may be even life-threatening in excessive heat, while there is growing evidence to suggest that their regular use may also interfere with fracture healing. Excessive use of oral antibiotics is also a matter for concern since these can lead to antibiotic resistance.

Int J Sports Med 2006; 27:919-925