Journal published by the Hellenic
Psychiatric Association

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The role of physical activity in physical and mental development and well-being was noted for the first time in the classic antiquity.Many centuries later, systematically organised epidemiologic studies highlighted the beneficial effects of exercise in the preventionof cardiovascular diseases and indicated that people who exercise benefit higher quality of life and longer survival.

Our ancestors, who loved sports with passion, organised the first games, while the concept of exercise acquired philosophicaland moral content. Despite the moral and intellectual role of sports, the development of organised athletic events in our daysturned out to be a commercial fiesta. The winner is crowned not only with olive wreaths but also with huge amounts of money and popularity.

At the same time the quest for greatness has driven many athletes and coaches to push for unfair advantages by the use ofperformance-enhancing (ergogenic) drugs, commonly referred to as “doping". The use of pharmacologically active substances toimprove performance in work or sports goes back centuries, but has increased dramatically after the second world war, leading toa development of a "black market" of steroids and anabolics. In sports, doping refers to the use of performance-enhancing drugs,particularly those forbidden by organizations that regulate competitions. The most commonly used substances are androgens andanabolic steroids, stimulants (amphetamines, cocaine, ephedrine), beta2 agonists, erythropoetin, growth hormone, glucocorticoids,opioid analgesics and diuretics. Their adverse effects are usually associated with endocrine disorders, cardiovascular events, liverand renal failure. Concerning their psychotropic action, these substances can cause physical and psychological dependence,depression, mania, mood swings, psychotic episodes, increased aggressiveness and irritability, confusional states and cognitive impairment.

The medical community plays a crucial role in the fight against doping. The doctors owe to inform athletes about the painful anddangerous effects of doping substances in physical and mental health, as well as about their psychotropic action.

Medical professionals owe to support education and awareness-raising programmes, since sufficient knowledge andtraining could be the first step in the fight against doping. A valid and scientific approach that will shed light on metabolic andneuropsychiatric properties of these substances, which are unknown to the wide public, is essential.

Adolescents is a special target group in the field of preventio since they enter for first time in the world of professional sports , withhigh motivations, while due to their enthusiasm they can even sacrifice their health for an athletic success. The medical communityowes to indicate the value of life against any professional success with harmful for health or even fatal consequences. The doctor'srole goes along with the protection of health and the improvement of quality of life and not with interventions for the increase ofathletic performance.

Unfortunately, recent developments in knowledge, research and treatment of diseases is accompanied by a correspondingevolution of doping methods, and even genetic techniques used to create super athletes nowadays.

Before its too late for many athlete lives, the medical community in collaboration with sports organizations and state institutionsis compelled to take action against doping with increased awareness, to contribute in prevention and repression of this new medicaland social problem. At first stage measures to prohibit the availability of performance enhancing drugs, including measures againsttrafficking are considered essential.

loannis A. Liappas
Professor of Psychiatry, Chairman of the ATHENA program, 1st Psychiatric Unit,
University of Athens, School of Medicine, Eginitio Hospital


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