β-adrenergic agonists and β-antagonists in sport performance: a narrative synthesis of pharmacological effects and anti-doping implications

Abstract

Introduction. In the context of increasingly intense athletic competition, athletes are motivated to enhance their performance through various methods, including the use of pharmacological substances that act on the adrenergic system. Among these, β2-adrenergic agonists are employed for their metabolic effects and their role in increasing endurance, whereas β-adrenergic antagonists are used in precision sports to reduce tremor and control anxiety. Both classes of substances present potential benefits as well as health risks, and are subject to strict regulations in high-performance sports. Material and methods. A theoretical study was conducted based on the analysis of specialized scientific literature, aiming to evaluate the impact of β2-adrenergic agonists and β-adrenergic antagonists on athletic performance. Additionally, the current regulations of the World Anti-Doping Agency (WADA) were analyzed. Results. β2-adrenergic agonists may contribute to the stimulation of muscle protein synthesis, enhancement of energy metabolism, and delay in the onset of fatigue. However, their use is associated with significant cardiovascular and metabolic side effects. β-adrenergic antagonists are effective in reducing tremor and sympathetic activation in precision sports but may decrease overall exercise capacity and induce bradycardia or chronic fatigue. Improper use of these substances can lead to severe sanctions in the context of athletic competitions. Conclusions. Although β2-adrenergic agonists and β-adrenergic antagonists may offer certain advantages depending on the specific nature of the sport, their use must be strictly medically regulated and comply with anti-doping standards. Careful evaluation of the risk-benefit ratio is essential for safeguarding athletes’ health and preserving the integrity of competition.