Effects of pseudoephedrine on parameters affecting exercise performance: a meta-analysis

Abstract

BackgroundPseudoephedrine (PSE), a sympathomimetic drug, commonly used in nasal decongestants, is currently banned in sports by the World Anti-Doping Agency (WADA), as its stimulant activity is claimed to enhance performance. This meta-analysis described the effects of PSE on factors relating to sport performance.MethodsAll included studies were randomised placebo-controlled trials and were conducted in a double blind crossover fashion. All participants (males and females) were deemed to be healthy. For the primary analysis, standardised mean difference effect sizes (ES) were calculated for heart rate (HR), time trial (TT) performance, rating of perceived exertion, blood glucose, and blood lactate.ResultsAcross all parameters, effects were trivial with the exception of HR, which showed a small positive increase in favour of PSE ingestion (ES = 0.43; 95% confidence interval: − 0.01 to 0.88). However, subgroup analyses revealed important trends. Effect sizes for HR (increase) and TT (quicker) were larger in well-trained (VO2 max (maximal oxygen consumption) ≥ 65 ml/kg/min) and younger (< 28 years) participants, for shorter (< 25 mins) bouts of exercise and when PSE was administered less than 90 min prior to performance. There was evidence of a dose-response effect for TT and HR with larger doses (> 170 mg) resulting in small (ES = − 0.24) and moderate (ES = 0.85) effect sizes respectively for these variables.ConclusionsWe conclude, however, that the performance benefit of pseudoephedrine is marginal and likely to be less than that obtained from permitted stimulants such as caffeine.

Nasal Injuries and Issues in Athletes

“…Interestingly, researchers performed a meta-analysis using randomized controlled trials to evaluate the relationship between pseudoephedrine and various performance-related factors, including heart rate, time trial performance, rating of perceived exertion, blood glucose, and lactate. Aside from small increases in heart rate, the results were overall negligible and unlikely to provide more performance benefits than the already permitted stimulants like caffeine (15).…”

Pseudoephedrine—Benefits and Risks

“…Pseudoephedrine is a sympathomimetic with a mixed mechanism of action, direct and indirect. It indirectly stimulates alpha-adrenergic receptors, causing the release of endogenous norepinephrine (NE) from the granularity of neurons, while it directly stimulates beta-adrenergic receptors [ 11 , 12 , 13 ].…”

“…This list is a mandatory international standard and is updated annually by the World Anti-Doping Agency (WADA), which is part of the World Anti-Doping Programme. The current list has been in effect since 1 January 2021 [ 12 , 13 , 40 , 41 ].…”

"Alkaloids Isolated from Ephedra Alata: Characterization and Protective Effects Against Cisplatin-Induced Liver and Kidney Injuries in Mice"

“…The antioxidant activity of the extract was determined using the free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, as described earlier with some modifications [24]. Briefly, 200 µL of AE (4-300 µg/mL) were mixed with 3.8 mL DPPH solution and incubated in the dark at room temperature for 1h.…”