Physicians should possess specific diagnostic and pharmacotherapeutic skills in order to recognize symptoms associated with doping use. It is important to be on the alert in athletes and fitness enthusiasts for physical and psychological changes due to use of anabolic steroids such as acne, stretch marks, gynecomastia, signs of acromegaly, irascibility and lethargy. Stimulants such as amphetamines, ephedrine and cocaine lead to fat loss and increased alertness; their main side effects are cardiac problems, behavioural changes and addiction. In addition to anabolic steroids and stimulants, erythropoietin, growth hormone, diuretics and glucocorticoids are regularly used to improve sport performance. In cycling, a biological passport will be used in an attempt to detect doping use. In future, the Olympic motto 'citius, altius, fortius' (faster, higher, stronger) will have ground-breaking consequences for the performance and health of top athletes.