CLINIC: Running on Ritalin

Tue, 6 Dec. 2011 - 1:17 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:
I am wondering about the effects of Ritalin, for Adult Attention Deficit Disorder, on heart rate and running performance. I coach adult runners and have a runner who tells me his heart rate was very high during his college cross-country training: 150 to 170 during an easy jog. I requested a physician’s clearance from him—am I being overly cautious?
 
Jim Bonaparte

ANSWER:
Since Ritalin is a stimulant (of adrenalin and other catecholamines), it can increase blood pressure and heart rate. However, as a practical matter, the increases are variable and of the order of 5 to 10 mmHg of blood pressure and 5 bpm for heart rate. Most of the reports in the medical literature are about children.
 
My advice would be that an exercise program can be pursued. I would monitor heart rate and proceed cautiously at first; you can then increase intensity and duration of training.
 
Charles Schulman, MD

ANSWER:
This stimulant and others similar to it can result in a somewhat increased resting heart rate. However, these drugs should not have a significant impact on the safety or effectiveness of running for fitness. I am unaware of any information about the effects on competitive performance. Although the scenario you describe sounds safe to me, I share your concern for the safety of intense training in adult runners who are taking medications on a regular basis. I certainly think it is reasonable to ask for a note from your runner’s physician, ensuring the appropriateness of this sort of workout.
 
Theodore N. Keltz, MD
 
(RUNNING & FITNEWS®  April / May 2007 • Volume 25, Number 3)
 
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