Anabolic androgenic steroids: what the psychiatrist needs to know

Abstract

Anabolic androgenic steroids (commonly known as anabolic steroids) are synthetic derivatives of the hormone testosterone. They are being increasingly used by professional and recreational athletes to enhance performance, and by men and women to improve physical appearance. This article discusses the characteristics of such steroid ‘misusers’ and the techniques of use. It highlights the psychiatric complications associated with these steroids, including increased risk of aggression, personality disorders, psychosis and mood disorders, particularly manic symptoms. Medical complications of steroid use are common and frequently reversible. Use is associated with an increased risk of injury, cardiovascular events, gastrointestinal complications, virilisation in women, and gynaecomastia and testicular atrophy in men. Whether addiction to these steroids can occur is debatable, but there is evidence for dependence and a withdrawal syndrome. Steroid use may be a ‘gateway’ to other addictions. Users are often reluctant to seek treatment and the psychiatrist's role in the recognition and management of use is presented.

Prevalência de uso de recursos ergogênicos em praticantes de musculação na cidade de João Pessoa, Paraíba

“…A preocupação com a imagem corporal também parece ser recorrente nos demais países ocidentais (Tsitsimpikou et al, 2011;Molinero;Már-quez, 2009), no tocante aos motivos para o uso de EAAs. Os principais objetivos referidos baseiam-se na procura do aumento da performance esportiva e/ou na obtenção de admiração por ter um corpo ''perfeitamente torneado'', além de aumento da libido e do bem-estar (Rashid et al, 2007;Parkinson e Evans, 2006;Cohen et al, 2007).…”

Nandrolone decanoate induces cardiac and renal remodeling in female rats, without modification in physiological parameters: The role of ANP system

“…Most often, individuals misuse these steroids to increase muscle mass and improve their physical shape without great concern for the adverse effects that can be caused by these substances (Rashid and Osmerod 2007). The excessive use of AAS can have acute and chronic side effects on different tissues as brain, kidneys, heart and vasculature (Amsterdam et al 2010).…”

Men regret anabolic steroid use due to a lack of comprehension regarding the consequences on future fertility

“…). Similarly, mood affective disorders have been recognised as a complication of AAS use with case reports describing everything from unspecified mood disturbances (Lindstrom et al ., ) as well as hypomania, mania, irritability and feelings of power and invincibility (Rashid et al ., ). In our study population, spousal communication does not appear to be an issue, and while we were unable to capture any psychiatric disorders, mood disturbances were similar between men with and without regret.…”