The New York Times features Viagra as performance enhancing drug (PED)

The New York Times carries a comprehensive review of research on the performance enhancing value of Viagra. 

When George Downey volunteered along with  other lacrosse players at Marywood University  to take ViagraFacebook page. for a study, he received a snickering nickname from his high school coach. His parents jokingly told their friends. Inquiring minds sent messages to his to his Facebook page.

“They’re making fun of me,” Mr. Downey, 19, said good-naturedly. “Deep down, I think they’re looking for tips.”

Except that the Marywood study does not involve the bedroom, but the playing field. It is being financed by the World Anti-Doping Agency, which is investigating whether the diamond-shaped blue pills create an unfair competitive advantage in dilating an athlete’s blood vessels and unduly increasing oxygen-carrying capacity. If so, the agency will consider banning the drug.

Sildenafil citrate (Viagra) is a NO inhibitor that increase blood flow to various organs, and thus the use for impotence.

(NO binds to the receptors of the enzyme guanylate cyclase which results in increased levels of cyclic guanosine monophosphate (cGMP), leading to smooth muscle relaxation (vasodilation) in the corpus cavernosum, resulting in increased inflow of blood and an erection. Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) which is responsible for degradation of cGMP in the corpus cavernosum)

However increasing blood flow could also be performance enhancing.  And thus the study.

Viagra, or sildenafil citrate, was devised to treat pulmonary hypertension,  or high blood pressure in arteries of the lungs. The drug works by suppressing an enzyme that controls blood flow, allowing the vessels to relax and widen. The same mechanism facilitates blood flow into the penis of impotent men. In the case of athletes, increased cardiac output and more efficient transport of oxygenated fuel to the muscles can enhance endurance.

“Basically, it allows you to compete with a sea level, or near-sea level, aerobic capacity at altitude,” Kenneth W. Rundell, the director of the Human Performance Laboratory at Marywood, said of Viagra.

There are skeptics:

Some experts are more skeptical. Anthony Butch, the director of the Olympic drug-testing lab at U.C.L.A., said it would be “extremely difficult, if not impossible” to prove that Viagra provided a competitive edge, given that the differences in performance would be slight and that athletes would probably take it in combination with other drugs. Scientists have the same uncertainty about the performance-enhancing effects of human growth hormone, though it is banned. But some athletes do not need proof — only a belief — that a drug works before using it, Dr. Butch said.

There is evidence that Viagra may give an edge to athletes (and note Roger Clemens was suspected of popping the blue pills):

Interest in the drug among antidoping experts was further increased by a study conducted at Stanford University and published in 2006 in The Journal of Applied Physiology. The study indicated that some participants taking Viagra improved their performances by nearly 40 percent in 10-kilometer cycling time trials conducted at a simulated altitude of 12,700 feet — a height far above general elite athletic competition. Viagra did not significantly enhance performance at sea level, where blood vessels are fully dilated in healthy athletes.

A 2004 German study of climbers at 17,200 feet at a Mount Everest base camp, published in The Annals of Internal Medicine, found that Viagra relieved constriction of blood vessels in the lungs and increased maximum exercise capacity.

And a small bit of evidence the drug is used by elite level athletes:

There is some suspicion that Viagra may be used to circumvent doping controls in cycling, which has faced waves of scandal. Last May, the cyclist Andrea Moletta was removed from the Tour of Italy after a search of his father’s car turned up 82 Viagra pills, as well as syringes concealed in a tube of toothpaste, according to news accounts. An investigation ended without formal accusations of doping.

The Times looks at the use of Viagra, and the particular study form Marywood.  However, remember that the study doesn't evaluate professional athletes, and thus will have that limitation.  A drug can always show different effects on different populations, so conclusions must be tempered.

 

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