Depression in Athletes and Antidepressant Therapy: Implications for Performance, Recovery, and Training Adaptation

Abstract

Depression is a prevalent mental health disorder affecting both the general population and athletes, despite the latter often being perceived as psychologically resilient. Athletes are exposed to unique stressors such as performance pressure, injuries, overtraining, and psychosocial challenges, which may increase their vulnerability to depressive symptoms. Pharmacological treatment, particularly with antidepressants, plays a central role in the management of moderate to severe depression; however, its potential impact on physical performance, recovery, and training adaptation remains a relevant concern in sports medicine.The aim of this study was to evaluate the role of antidepressant therapy in athletes, with particular emphasis on different pharmacological classes and their effects on performance and recovery. This study was conducted as a narrative review of literature identified through PubMed, Scopus, and Web of Science. Studies were selected based on predefined eligibility criteria focusing on antidepressant use in athletes or physically active individuals and their effects on physiological, psychological, and performance-related outcomes. Data were analyzed qualitatively.The findings indicate that different classes of antidepressants exert distinct effects. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used and generally well tolerated but may contribute to fatigue and reduced motivation. Serotonin–norepinephrine reuptake inhibitors (SNRIs) may improve energy levels and pain modulation, although they can affect cardiovascular responses. Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are less suitable due to unfavorable side-effect profiles. Atypical antidepressants demonstrate heterogeneous effects, highlighting the importance of individualized treatment.In conclusion, antidepressant therapy is essential in managing depression in athletes but requires a personalized and interdisciplinary approach.