Key result
Acute antidepressants link to ~0.5 points higher RPE without altering objective physical performance.
Why the study?
Antidepressants are commonly prescribed in athletes with depressive disorders, but their potential effects on physical performance and perceived exertion remain unclear.
Does acute antidepressant administration affect objective physical performance and perceived exertion in male athletes?
Meta-Analysis (n=99)
Does acute antidepressant administration affect objective physical performance and perceived exertion in male athletes?
Short-term antidepressant administration in athletes is associated with a small increase in perceived exertion but no consistent impairment in objective physical performance.
May increase perceived exertion during short-term use in athletes; extends sparse evidence but leaves practice implications open pending larger trials.
INTRODUCTION: Antidepressants are commonly prescribed in athletes with depressive disorders, yet their potential effects on physical performance and perceived exertion remain unclear, and existing evidence is limited and inconsistent. AIM: This systematic review and meta-analysis aimed to evaluate the effects of antidepressant use on objective physical performance and perceived exertion in athletes. METHOD: A systematic literature search was conducted in PubMed, the Cochrane Library, Web of Science, and SPORTDiscus through March 2025. Eligible studies were randomised controlled trials (RCTs) published in English that enrolled elite, competitive, or recreational athletes; compared antidepressant administration with placebo or no treatment; and reported at least one objective or subjective performance-related outcome. Meta-analyses were performed using random-effects models, and pooled mean differences with 95% confidence intervals (CI) were calculated. This systematic review and meta-analysis was registered in PROSPERO (CRD420251123740). RESULTS: Ten crossover RCTs involving 99 male athletes were included. Interventions included a norepinephrine reuptake inhibitor (reboxetine), a norepinephrine-dopamine reuptake inhibitor (bupropion), and selective serotonin reuptake inhibitors (fluoxetine or paroxetine). Acute antidepressant administration was associated with a small increase in rating of perceived exertion (RPE; mean difference 0.52 points on the Borg 6-20 scale, 95% CI 0.01-1.04; p < 0.05). No significant overall effects were observed for time-trial performance, mean power output, heart rate or blood lactate. However, subgroup analyses showed that reboxetine significantly impaired time-trial performance (mean difference 3.62 min, 95% CI 0.18-7.06; p < 0.05) and reduced mean power output (mean difference - 19.97 W, 95% CI - 36.87 to - 3.06; p < 0.05). CONCLUSION: Short-term antidepressant administration in athletes was associated with a small increase in perceived exertion, without consistent impairment in objective physical performance. As the current evidence derives exclusively from male athletes and acute exposure, further research should clarify its relevance to female athletes and to longer-term antidepressant treatment in athletes with depressive disorders.
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윤정하 et al. (2026) conducted a meta-analysis in Athletes (n=99). Antidepressants vs. Placebo or no treatment was evaluated on Rating of perceived exertion (RPE) (MD 0.52, 95% CI 0.01-1.04, p=0.049). Acute antidepressant administration in male athletes was associated with a small increase in rating of perceived exertion (MD 0.52 points) without consistent overall effects on objective physical performance.
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