A transição do uso acadêmico para o uso funcional: padrões de uso indevido de estimulantes em médicos com sintomas de TDAH

Objective: To systematically review the literature on patterns of misuse of prescription psychostimulants among medical students and resident physicians, analyzing how the motivations for use evolve throughout the progression of the medical career. Methods: A systematic review was conducted following the PRISMA guidelines, with searches in PubMed, LILACS, and the Cochrane Library. Thirteen articles published in the last 10 years that investigated the non-medical use of stimulants (such as methylphenidate and amphetamines) in this specific population were included. Results: The prevalence of non-prescribed use varies substantially, reaching alarming rates in medical residency, ranging from 35.1% to 45.6% in specialties such as surgery and obstetrics. The findings reveal a clear transition in the pattern of use: during the basic cycle, “academic use” predominates, aimed at retaining information and passing theoretical exams. However, upon entering the internship and residency, use becomes “functional.” At this stage, professionals turn to these drugs as a coping strategy to endure chronic sleep deprivation, uninterrupted clinical stress, exhausting schedules, and an intrinsic fear of failure. The situation is aggravated by the inherent ease of pharmacological access in the hospital environment and by invisible self-medication. Conclusion: Stimulant misuse reveals a collapse of neurocognitive adaptation strategies in the face of medical exhaustion. Institutional interventions are urgently needed to adjust workloads and to support neurodivergent physicians, aiming to dismantle the culture that normalizes pharmacological enhancement to the detriment of occupational health.