Meldonium – what is it and why did Sharapova use it?

This morning we woke up to news of yet another doping incident in sport. However, this case was slightly different to others –  Maria Sharapova openly declared that she had failed a drugs test. The question is to whether her story adds up.

The Latvian company manufacturing meldonium (otherwise known as mildronate), Grindeks, claim that the normal course for the drug is four to six weeks. However, this can be repeated;

Depending on the patient’s health condition… treatment course can be repeated twice or thrice a year.”

This may not fully explain how she claims to have taken the drug for the first time 10 years ago, and whether her usage was consecutive throughout these years.

In an article from The Guardian, I found that;

  • Meldonium is used to treat ischaemia: a lack of blood flow to parts of the body, particularly in cases of angina or heart failure (another name for cardiac ischaemia is coronary heart disease).
  • It is manufactured in Latvia and only distributed in Baltic countries and Russia. It is not approved by the Food and Drug Administration for use in the United States and is not authorised in the rest of Europe.
  • According to PubMed it is also used in neurological clinics to treat brain circulation disorders.

So from this evidence we may conclude that Sharapova had some form of cardiovascular disease, however there is evidence that points in the other direction (the cheating one);

  • Meldonium increases blood flow, which improves exercise capacity in athletes
  • WADA (the world anti-doping agency) found “evidence of its use by athletes with the intention of enhancing performance” by virtue of carrying more oxygen to muscle tissue.


Teenage mental-health crisis: Rates of depression have soared in past 25 years (BBC Article)


  • Rates of depression and anxiety among teenagers have increased by 70 per cent in the past 25 years.
  • The number of children and young people turning up in A&E with a psychiatric condition has more than doubled since 2009.
  • In the past three years, hospital admissions for teenagers with eating disorders have also almost doubled.
  • In a 2016 survey for Parent Zone, 93 per cent of teachers reported seeing increased rates of mental illness among children and teenagers and 90 per cent thought the issues were getting more severe, with 62 per cent dealing with a pupil’s mental-health problem at least once a month and an additional 20 per cent doing so on a weekly or even daily basis.


Mental health such a current topic, and this article publishing stats from The Guardian brings to light the problems many teenagers in society face. I searched for measures of depression (just to find out about the boundaries and tests), and found a test for depression that is entirely for paediatric (child) patients:

Paediatric Index of Emotional Distress (PI-ED) is a valid and reliable self-rating scale that screens children and young people for emotional distress.

The PI-ED assesses psychological distress using one brief questionnaire, comprising 14 questions that are presented on one page. It asks children and young people about their symptoms of anxiety and depression. A concrete cut-off score then clearly identifies individuals most in need of further clinical assessment and intervention.

There is a question of whether teenagers today do suffer from more mental illnesses, or whether they are more likely to seek help from medical professionals now so more cases are recorded.

Either way, various news articles pointing out flaws in the mental health system almost victimize sufferers, for example, by using extreme examples of;

The “cannibal killer” case of Peter Bryan – a mental health patient who police found eating one of his victims – shows the mental health system is struggling, campaigners say.”


“Mental health campaigners have blamed flaws in the system for the fact that a schizophrenic man was able to walk out of a psychiatric hospital and kill.” 

(both from the BBC website, 2005). These examples misrepresent sufferers of mental disorders hugely, almost insinuating that they are cold blooded murderers who will kill you after a single meeting of the eyes. This is so unfair.

However, things have changed since 2005 – mental illnesses are being recognised now as equal to physical disabilities. This will allow great steps to be made in terms of research and tackling mental illness.

Excitement at new cancer treatment

Cancer is a huge killer in the UK and the rates are rising. Half of us, at least once in our lifetimes, will hear the words: “you have cancer”. On the Cancer Research UK website, they suggest that the rise in instances of cancer is due to an ageing population;

“By far the biggest risk factor for most cancers is simply getting older. More than three-quarters of all people diagnosed with cancer in the UK are over the age of 60.

And this is because cancer is a disease of our genes – the bits of DNA code that hold the instructions for all of the microscopic machinery inside our cells. Over time, mistakes accumulate in this code – scientists can now see them stamped in our DNA. And it’s these mistakes that can kick start a cell’s journey towards becoming cancerous.”

-February 4, 2015 Greg Jones

However, on a positive note, more people are beating cancer than ever. Survival rates have doubled in the last 40 years, and half of the people diagnosed will survive for 10 years (an all time high). A major factor into this rise of cancer survival is through the raising of awareness of charities, such as Cancer Research UK and Macmillan.

I was just scanning through the BBC Health page and found this article (below). I found this interesting because the media is often a huge factor into misunderstandings of medical practice and research, such as Andrew Wakefield’s (1998) paper that found a ‘link’ between autism and the MMR vaccine (which caused hysteria and for parents to refuse the opportunity of the MMR vaccine for their children). He has since been removed from the medical register and the idea has been discredited. In this article, however, the journalist ensures that the readers realise that this is a small step.

Excitement at new cancer treatment


‘A therapy that retrains the body’s immune system to fight cancer has provoked excitement after more than 90% of terminally ill patients reportedly went into remission.

White blood cells were taken from patients with leukaemia, modified in the lab and then put back.

But the data has not been published or reviewed and two patients are said to have died from an extreme immune response.

Experts said the trial was exciting, but still only “a baby step.”

The news bubbled out of the American Association for the Advancement of Science’s annual meeting in Washington DC.

The lead scientist, Prof Stanley Riddell from the Fred Hutchinson Cancer Research Centre in Seattle, said all other treatments had failed in these patients and they had only two-to-five months to live.

He told the conference that: “The early data is unprecedented.” ‘

– By James Gallagher Health editor, BBC News website

Nick Peel (from the Cancer Research UK) suggested that the media were jumping the gun with the idea of a ‘cure’, considering that the data is from clinical trials. He described it as: “‘Extraordinary’ responses… but not cures”

Recommended Read

Stiff – Mary Roach

Had this book as a Christmas gift – well worth a read if you’re thinking of medicine as it includes the history of medicine in different countries (e.g: China) and how human remains were used in many medicines and remedies.

In the past, a part of Chinese marriage rituals required  women to cut off parts of their body and make it into a dish to honour their mother-in-law  –  the most common were porridges and soups (bit disgusting, but if it won the approval I guess it was worth it)

stiff - mary roach