This month, Irish Olympic show jumper Darragh Kenny was provisionally suspended by the FEI following the results of human anti-doping testing that occurred at the Longines FEI Jumping European Championships in A Coruña, Spain in July. 

The drug in question, according to a statement released by Horse Sport Ireland, involved a substance classified under Class S6 (Stimulants) on the World Anti-Doping Agency (WADA) Prohibited List. “Substances in this category may be found in certain prescribed medications used in the treatment of medical conditions such as attention deficit hyperactivity disorder (ADHD), anaphylaxis, and cold and flu symptoms,” the statement read. 

Kenny, who said he is fully cooperating with the FEI and the International Testing Agency (ITA), explained that the medication is part of a prescribed treatment for ADHD that he was taking under medical supervision. 

I want to emphasize that I never intended to gain any competitive advantage. My sole aim was to responsibly address a medical condition under professional guidance,” Kenny said. “I am deeply grateful to my National Federation, my sponsors, owners, clients, and the broader equestrian community for their support throughout this process.”

This is not the first time that ADHA medication has been made headlines in the wake of a major championships. After hackers circulated confidential records from WADA showing that five-time Rio Olympic medalist Simone Biles was legally using prescribed Ritalin for ADHD while competing, she went public about her condition in a series of tweets. 

“Having ADHD, and taking medicine for it is nothing to be ashamed of nothing that I’m afraid to let people know,” she wrote. 

American swimmer Michael Phelps, the most decorated Olympic athlete of all time, also struggled with ADHD as a child. It’s a condition that affects an estimated 7 million (11.4%) U.S. children aged 3–17 years, according to the CDC. In his memoir Beneath the Surface, Phelps explained that he took medications for several years but weaned himself off at age 13, feeling that the drugs were a “crutch.” 

But concerns about dependency aren’t the only reason that people with ADHD may struggle with prescribed medications, says author, neuroscience professor, and cognitive science PhD, Janet Jones. “People with ADHD don’t take Ritalin or Adderall because they want to. They take it because they have to in order to function properly,” she says. 

“The side effects include racing heartbeat, irritability, anxiety, headaches, increased blood pressure, skin rashes, digestive problems, weight loss, tremors, tics, diarrhea or constipation, mood swings, hives, dizziness, and nausea. I mention these to point out that any positive effect of these medications on performance is easily offset by the many problems they cause.” 

According to Jones, the most common prescribed stimulants used to treat ADHD—Ritalin and Adderall—work by helping patients increase their focus and reduce impulsive or hyperactive behavior by increasing dopamine and norepinephrine in the brain. 

“The medications do not cure ADHD; they reduce its symptoms—just as medications do for hundreds of other diagnosed disorders and diseases,” Jones says. 

“People who have been diagnosed with ADHD often experience lack of focus, trouble finishing tasks, feeling overwhelmed by multiple tasks, poor time management, and difficulty prioritizing multiple tasks. They tend to be impulsive, making decisions that are not well considered, and they tend to be hyperactive.” 

The result, Jones explains, often makes basic, daily activities that most of us take for granted (think: organizing our lives, keeping appointments, completing large projects) difficult for those who suffer from ADHD. “Often they are restless, try to do too many tasks at once, or carry out risky or impulsive behavior,” Jones explains, adding that about 70% of adults with ADHD suffer from insomnia as well.

While ADHD medications containing methylphenidate and amphetamine derivatives are currently prohibited by WADA—whose international standards the FEI follows, using the International Testing Agency (ITA) to administer them—Darragh Kenny would have had the ability to apply for a Therapeutic Use Exemption (TUE) prior to competing at the European Championships. 

Obtaining a TUE requires the completion of an application form and checklist, with a medical report submitted by the athlete’s treating physician or clinical psychologist, along with supporting documentation. Over the last three years, according to statistics, the FEI, via the ITA, has either approved or closed/withdrawn approximately 89% of the TUE applications it’s received, with a handful of results still marked as “pending”.

It should also be noted that, according to WADA Physician Guidelines for ADHD, it is not recommended that athletes with the condition stop established treatment protocols, medications included, during competition periods. “It is now generally considered that cessation of treatment can have a number of negative effects including an adverse effect on symptom control, which can take time to re-establish,” the guidelines explain

“This destabilizing of symptom control can also lead athletes to have an increase in risk-taking behaviors and can potentially increase their involvement in conflict situations (e.g. altercations with referees).”

What’s more, given that the chronic nature of ADHD and the fact that pharmacological treatment of individuals with the disorder usually takes place over many years, TUE durations may be granted for up to four years at a time for well-documented cases of an ADHD diagnosis on a stable dose medication. 

Whatever the reasoning behind Kenny’s failure to disclose or decision not to submit a TUE form in line with the FEI’s protocols for the European Championships—and one can only speculate as to whether or not this omission may have actually been influenced by his ADHD diagnosis—he would not be the only international rider to find himself in hot water for anti-doping violations involving a failure to declare prescribed ADHD medications. 

In May of 2018, three American eventing riders—Jennie Brannigan, Hannah Burnett, and Alyssa Phillips—failed drug tests that had taken place at the CIC3* Ocala Jockey Club International in November of 2017. 

All three tested positive for amphetamine and other ADHD-related drugs and faced a fine, disqualification of their results (included Burnett, who had won the CIC3* with Harbour Pilot), and a one-year suspension from competition. All three, however, also had prescriptions from a doctor for their ADHD medications and received prospective TUEs to use them in future competitions. 

Additionally, the FEI considered several mitigating factors while adjudicating their cases, including their inexperience with anti-doping, comprehensive medical documentation for their prospective TUEs—proving that they were not seeking an unfair competition advantage—the prompt admission and explanation for the reason behind their positive tests, and, in one incidence, the declaration of the prohibited substances on the competition’s Doping Control Form. 

It is unknown whether Kenny, 37, has previously applied for TUEs for his ADHD medications, or if this is a recent diagnosis and/or part of a new prescribed treatment plan. If so, his ADHD diagnosis in later life would not be unusual. “About half of ADHD patients are diagnosed in adulthood but report having had symptoms since childhood,” Jones explains. 

However the FEI Tribunal ultimately comes down on Darragh Kenny’s suspension, Janet Jones believes it is worth reexamining how we view the role of ADHD medications in sport, and on the whole. “If the FEI wishes to consider Ritalin and Adderall as ‘performance-enhancing’ medications in ADHD patients, it’s going to have to take a hard look at other chemical substances as well,” she says. 

“Does the FEI wish to prohibit nicotine, aspirin, antihistamines, statins, antidepressants? I don’t think so, but that’s the equivalent of prohibiting Adderall and Ritalin for people who have been diagnosed with ADHD. Is the FEI going to prohibit diabetics from performance on the grounds that insulin helps them achieve mental clarity? Again, I don’t think so.

“My opinion is that if a competing athlete has been diagnosed with ADHD by a medical doctor, they have the right to take prescribed medications to treat it,” Jones continues. “And they should have the right to compete just as anyone else does in the show arena.”