L'utilisation et la prescription des corticoïdes en médecine du sport

[What illegal substances are used by sportsmen? a study in Midi-Pyrénées Doping Preventing Medical Centre (AMPD-MP)]

OBJECTIVE

Doping Preventing Medical Centres (Antennes Médicales de Prévention du Dopage) were established in France in 2000 in order to help sportsmen using illegal substances. These services are also information centres on illegal substances (drugs or others) used in sport. The aim of the study was to analyze the characteristics of sportsmen outpatient clinics in Antenne Médicale de Prevention du Dopage Midi-Pyrénées (AMPD-MP).

METHODS

We present the results of outpatient clinics in AMPD-MP from 2002 to 2008. A descriptive analysis of demographic data, substances used and sports practised were performed.

RESULTS

During this 7 year-period, 35 outpatient clinics were performed [32 men, 3 women, mean age: 28 years (extreme values: 18-47; 10 patients ≥ 30 years)]. They were mainly involved in national (16), international (8) or regional (7) competitions. The main sports involved were rugby (9) followed by cycling (5), athletics (3) and body-building (3). The most frequently used illegal substances were cannabis (15) followed by glucocorticoïds (9), androgens (4), indirect sympathomimetics amphetaminics (4), beta 2 adrenergic agonists (2) and NSAIDs (2). Two veterinary substances (clenbuterol, boldone-veterinaire) were also found in body-builders.

CONCLUSION

This study shows a clear under use of Doping Preventing Medical Centres by sportsmen and practitioners. It also indicates a relative high age for sportsmen referred to the centre. The main sports involved were rugby and cycling. Cannabis and glucocorticoïds were the drugs more often involved in doping behaviours.

Los glucocorticoides y el rendimiento deportivo

There are endogenous and exogenous glucocorticoids whose hormonal properties are derived from hydrocortisone. The physiological and pharmacological effects of the glucocorticoids are antiinflammatory and immunosuppressor, basically. As other drugs, they have secondary effects, which are minimum when the prescription is correct and controlled by a medical doctor. Although antiinflammatory, antialgic, anxiolytic, and antiasthenic effects have been described in corticosteroids, all these effects have been seen at patients at rest and there is no study to confirm these effects in subjects that do exercise. These studies that tend to analyze the effects of corticosteroids on sport's performance have concluded that there is not any improvement of performance.