Mood Swings

A psychiatrist surveys the mind and the wider world

Ritalin on First, Dexedrine on Second

Eight percent of baseball players have permission to take amphetamines.


Apparently 8% of all baseball players have medical permission to take amphetamine stimulants, presumably for adult ADHD. Now this is something: perhaps psychiatric researchers on ADHD need remediation in the minor leagues, because nothing we thought we knew about ADHD would explain this report.

ADHD in children is thought to peak from age 7 to early adolescence. The Centers for Disease Control interviewed thousands of children across the country and established a prevalence of ADHD of about 8% in males and somewhat less in females. About half needed stimulant medications clinically, the remainder managed without medications. Among studies conducted by those who are proponents of a high frequency of adult ADHD, it is still estimated that ADHD symptoms do not persist into adulthood in at least one-half of children; older studies reported that 90% of kids outgrew ADHD.

With these estimates one would expect, at most, an adult ADHD prevalence of about 4%, and possibly as low as 1% or less. Indeed, the main national psychiatric diagnosis study, the National Comorbidity Survey, reported an adult prevalence of about 4.4%.

College students abuse amphetamine stimulants at a rate of about 14%, even higher than baseball players. Some students share their amphetamines with friends. If 8% of baseball players are prescribed amphetamines, one might expect that a certain higher number of their teammates may volunteer to share the burden. Statistically, someone on the baseball field, at any moment, is using, or abusing, amphetamine stimulants.

A baseball player representative argues that players are young and male and able to receive proper medical attention; hence the high prescription rate. But the NCS study identified the children and adults who actually have the illness, diagnosed by the researchers, not those who had access to care. The rates are much lower than the baseball union representative defends.

Perhaps there is something special about college students and baseball players, though - something that makes them uniquely different than the average kid or the average accountant. They do after all, get grade point and batting averages.

The steroid era is over, the ritalin era has begun; fortunately change has come to baseball.

Nassir Ghaemi, M.D., M.P.H.,

is Professor of Psychiatry at Tufts University School of Medicine, and Director of the Mood Disorders Program at Tufts Medical Center in Boston. more...

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