‘ADHD’ TUE Applications

Special Note for Attention Deficit Hyperactivity Disorder (ADHD) TUE Applications

Athletes who have ADHD and who have been prescribed the use of a prohibited substance and need to apply for a TUE should take note of the important information below from the WADA Medical Information to Support the Decisions of TUE Committees on the Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adults. This document is available on the WADA website (click here).

The essential feature of attention deficit/hyperactivity disorder is a persistent pattern of inattention and or hyperactivity-impulsivity that interferes with functioning and development. The requirement that several symptoms be present before age 12 years conveys the importance of a substantial clinical presentation during childhood. Manifestations of the disorder must be present in more than one setting (e.g. home, school, work). There is an exclusion that the symptoms should not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal)[1].

The criteria in the hyperlink above will be used as a reference when evaluating the supporting documentation pertaining to granting a TUE for the treatment of ADHD.
 What medical evidence is needed in an ADHD TUE application?  
Athletes with ADHD who submit a TUE application for stimulants require the following medical evidence to support the diagnosis:
  • A full medical report from a physician (either psychiatrist, paediatrician or other physician specialized in diagnosing ADHD) that includes:
    • age of onset
    • presence of symptoms across two or more settings
    • how symptoms interfere with daily functioning
    • date of diagnosis and how diagnosis was made based on DSM 5 criteria
    • start of treatment, symptoms on and off treatment
    • evidence of regular reviews of the athlete by the physician
    • current medication, route of administration and dose.
Where diagnostic reports are older than twelve (12) months, these must be accompanied by documentation of regular clinical reviews of the athlete by the treating physician:
  • a standard recognized ADHD diagnostic test that the athlete has completed and the physician’s interpretation of the test results;
  • supplementary reports (if available) by treating psychologist, school teachers, parent/guardian;
  • where school performance is main indication for treatment, academic results before and after starting treatment.
[1] American Psychiatric Association, The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Washington, DC: American Psychiatric Association; 2013.