Advances in Psychiatric Treatment (2007) 13: 203-211. doi: 10.1192/apt.bp.105.000935
© 2007 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Rashid, H.
Right arrow Articles by Day, E.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Rashid, H.
Right arrow Articles by Day, E.

Anabolic androgenic steroids: what the psychiatrist needs to know

Harry Rashid, Sara Ormerod and Ed Day

Harry Rashid is an innovative general practice registrar with an honorary contract with Birmingham Heartlands and Solihull NHS Trust, having initially worked in general adult psychiatry for the Birmingham and Solihull Mental Health NHS Trust. He has a specialist interest in sports medicine and anabolic steroid misuse. Sara Ormerod is a specialist registrar in old age psychiatry currently working for Birmingham and Solihull Mental Health NHS Trust. Her clinical and research interests include the interface between physical and psychiatric disorders. Ed Day is a senior lecturer in addiction psychiatry at the University of Birmingham (Department of Psychiatry, Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2QZ UK. Email: e.j.day{at}bham.ac.uk), and an honorary consultant psychiatrist with the Birmingham and Solihull Mental Health NHS Trust. His research interests include developing innovative pharmacological and psychological treatments for alcohol and drug dependence.

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.