Evidence map›Paper›PMID 42380727›Full record

ReviewSports medicine - open2026

Prescribing Antidepressants for Elite Athletes: Is There Evidence to Support Best Practices in Sports Psychiatry? A Scoping Review.

Rafael Zini, João Maurício Castaldelli-Maia, Malte Christian Claussen, Maria Olivia Pozzolo Pedro, Renner Santos Borges, André Furtado de Ayalla Rodrigues, Lara Ferreira Camacho, Gustavo Bonini Castellana

Abstract readReview
In one paragraph

Review in Sports medicine - open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rafael ZiniMedical School, Psychiatry Institute, University of Sao Paulo, Dr. Ovídio de Carvalho St., 785, Cerqueira Cesar, Sao Paulo, SP, Brazil. rafaelzinimd@gmail.com.ORCID http://orcid.org/0009-0003-0202-6255
João Maurício Castaldelli-MaiaUniversity of Sao Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0001-9621-2291
Malte Christian ClaussenResearch Group Sports Psychiatry, Center for Psychiatric Research, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich, University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-8415-3076
Maria Olivia Pozzolo PedroUniversity of Sao Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0003-1336-093X
Renner Santos BorgesUniversity of Sao Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0001-8893-717X
André Furtado de Ayalla RodriguesFaculdade Pernambucana de Saúde, Recife, Brazil.ORCID http://orcid.org/0000-0002-2372-2423
Lara Ferreira CamachoState University of Campinas, Campinas, Brazil.ORCID http://orcid.org/0009-0003-0888-5632
Gustavo Bonini CastellanaUniversity of Sao Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0001-5179-5198

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElite athletes face unique mental health challenges, yet the use of antidepressants in this population remains underresearched. Despite the prevalence of depressive and anxiety symptoms, there are no specific pharmacological guidelines tailored to athletes' mental health needs or performance demands.

objectiveThis scoping review aimed to explore the current literature on the use of antidepressant medications among elite athletes with symptoms of or who were diagnosed with depressive or anxiety disorders, focusing on treatment effectiveness, safety, performance, and, mainly, the athlete's well-being.

methodsA systematic search of PubMed, Embase, and PsycINFO (February 18-20, 2025) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Predefined terms related to athletes, antidepressants, and psychiatric disorders were employed. Studies were included if they involved elite athletes treated with antidepressants for major depressive disorder, bipolar depression, or generalized anxiety disorder. The data were charted and narratively synthesized.

resultsAmong the 34,131 records screened, 15 met the inclusion criteria: 11 narrative reviews, 2 systematic reviews, 1 survey, and 1 position statement. Most studies provide recommendations on the basis of the general population, offering limited data on elite athletes with formal diagnoses. Few studies have reported treatment durations or mental health outcomes. While performance effects have been emphasized, psychological recovery is rarely addressed. Selective serotonin reuptake inhibitors-particularly escitalopram, fluoxetine, and sertraline-were the most commonly suggested drugs.

conclusionThere is a lack of robust evidence to guide antidepressant use among elite athletes. Future research should prioritize trials involving clinically diagnosed athletes, structured protocols, and outcomes centered on mental health and well-being rather than merely performance.

Indexed as

AntidepressantsAnxietyDepressionElite athletesMental healthPharmacological treatmentSports psychiatry

Identifiers

PMID42380727
PMCPMC13319284

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.