Thus, 2–3 times the usual adult rate of ADHD in baseball players is alarming. Athletes may see stimulants as a way to help maintain physical fitness for their competitive sport or to improve their concentration. Certainly some of the players getting prescriptions for ADHD medications may have a legitimate medical need and without treatment, players till manifesting the symptoms of untreated ADHD would be at a disadvantage to non-ADHD players. A therapeutic dose of MPH will benefit concentration, Inhibitors,research,lifescience,medical and may improve motor coordination. Prescription stimulants to treat ADHD could be used as performance enhancing drugs (PEDs); however, a proper diagnosis

would prevent athletes from abusing the TUE status to “cheat within the rules.” Some athletes will only take medications episodically for school testing or for studying purposes. Others may feel that their sport performance is improved on stimulants, whereas others may temporarily stop taking them so that their sports play is more random and Inhibitors,research,lifescience,medical unfocused, which they feel improves their performance (Pelham et al. 1990). Potential adverse affects of chronic stimulant use ADHD is now recognized as a chronic disorder that continues into adulthood;

therefore, some individuals take stimulants such as MPH and d-AMP for years. The medical literature Inhibitors,research,lifescience,medical provides abundant data to support the potentially positive effect of stimulants for the majority of children, adolescents, and adults with ADHD, and stimulants have been considered to be relatively safe (Elia et al. 1999; Brown et al. 2005). However, reports Inhibitors,research,lifescience,medical of adverse events in conjunction with the use of these drugs have raised concern about their safety. Large doses of stimulants can lead to psychosis, seizures, and cardiovascular events. The induction of schizophrenic-like states in AMP abusers is Inhibitors,research,lifescience,medical well documented, although the onset of such states in children on prescribed

doses of stimulant medication is observed far less often (Polchert and Morse 1985; Masand et al. 1991; Murray 1998). Surles et al. (2002) published a case report of psychotic reactions to AMP (10 mg/day) in an adolescent ADHD patient. The patient displayed GSK-3 many of the characteristics of AMP-induced psychosis including visual hallucinations, delusions, anorexia, flattening of antagonist Enzalutamide affect, and insomnia. It is thought that the mechanism of AMP-induced psychosis is mediated by dopaminergic excess. As the patient’s symptoms disappeared when taken off the stimulant medication, it suggests that the psychosis was indeed secondary to AMP. The most commonly observed cardiovascular effects linked with ADHD stimulant medications include hypertension and tachycardia. In addition, cardiomyopathy, cardiac dysrhythmias, and necrotizing vasculitis have been described. In February 2005, the brand medication Adderall XR (Shire BioChem Inc, Quebec, Canada) was withdrawn from the Canadian market by Health Canada.