terms for synthetic substances related to the naturally occurring male sex hormone testosterone

have both muscle building (anabolic) and masculinizing effects and are therefore used to enhance athletic performance and appearance

Illicit use occurs among adolescents and adults – both male and female athletes and nonathletes

One study◦ 55% of 27 year old male and 10% 24 year old

female body builders use anabolic steroids◦ More than 1 million Americans have used

anabolic steroids either to improve athletic ability or to improve personal appearance

◦ 4-12% high school boys have used/abused AAS (many starting by age 11)

Juice, Roids, Gym Candy, Pumpers, Stackers, Balls or Bulls, Weight Trainers, Arnies, A’s or Anabolics

Swallowed in tablets or liquid, injected** or patches

Users take them in patterns called “cycling”◦ take them over a specific period of time,

stop, then start taking them again “stacking” –

◦ Taking different types of steroids in combination with other drugs

Highly lipid soluble◦ Implications:

Routes of administration ◦ Significant 1st pass metabolism

Risk for liver

Promote increased muscle mass and enhance physical strength

Increase endurance, physical appearance, and athletic performance

2003 - ◦ previously undetectable anabolic steroid

tetrahydrogestrinione incited furor in media when high prof

◦ High profile professional athletes admitted to using this drug.

March 2004- ◦ FDA classified them as an illegal substance and now

tests are available to detect drug in urine. Androstenedione – Mark McGwire –

Used to treat delayed puberty prevention of weight loss in renal failure Muscle wasting in males with HIV/AIDS

related weight loss. Repair of severe muscle loss following

trauma,

T synthesized principally in Leydig cell of testes Once in bloodstream, T (or the anabolic steroid)

passes through the cell walls of the target tissues and attaches to steroid receptors in the cytoplasm of cells

Hormone receptor complex carried into the nucleus of the cell and then attaches to DNA (genetic transcription; mRNA produced)

Translation of RNA results in production of new proteins that leave the cell and mediate biological functions

Negative feedback loop

Effects on negative feedback loop abnormally high levels of steroids

◦ shut off production of GRF FSH and LH◦ shut off spermatogenesis

Cardiovascular◦ Increase cardiac risk factors◦ Hypertension◦ Increase in ldl/hdl ratio◦ Increased risk for strokes/cardv event

Hepatic (if taken orally)◦ Elevated liver enzymes◦ Liver tumours

Males◦ Decreased T production◦ Abnormal spermatogenesis◦ Transient infertility◦ Testicular atrophy

Females◦ Altered menstruation

Increased thyroid function Immune function (decreased

immunoglobulin) Premature closure of bony growth centers Tendon degeneration (so inc risk of tears)

Males:◦ Gynecomastia◦ Testicular atrophy◦ Acne◦ Acceleration of male-pattern baldness

Females:◦ Clitoral enlargement◦ Acne◦ Increased facial/body hair◦ Coarsening of skin◦ Male pattern baldness◦ Deepened voice

Severe mood swings Aggression (?) Psychotic episodes (?) Depression suicideality

Adolescence –hormonally sensitive developmental period◦ Organizational vs activation effects of steroids

Idiosyncratic in adults Young males?

◦ “roid rage” Animal models

(Farrell et al 2004)◦ Male rats given AAS or T (5 days/week for 5 weeks

before began testing) and then 4 more weeks during testing

◦ Tested in 3 environments Home cage Neutral cage Opponents cage

◦ Tested at three time points During AAS treatment During AAS withdrawal After AAS withdrawal

AAS exposed males tested with◦ Low threat (smaller male)◦ High threat (cage of male w estrus female)

Aggression toward females◦ Estrus vs nonestrus females ◦ Provoked vs not

AAS cocktails

Differences in AAS◦ Testosterone – androgenic and anabolic

Several effects on numerous nt in adolescent brain Including 5HT

◦ Stanozolol – high anabolic; low androgenic affinity Seems to inhibit androgen-sensitive behaviors

◦ Nandrolone – highest affinity for androgen receptor Has both androgenic and anabolic

Stacking in rodent studies very limited

AAS treated males displayed aggression in home cage

WD from large doses of anabolic steroids can be accompanied by moderate to severe depression, fatigue, restlessness, insomnia, etc, dissatisfaction with body image – suicide risk

Still – no defined psychiatric wd system have been described

Congressional hearings (between 1988-1990) held to determine the extent of AAS abuse and whether the Controlled Substances Act should be amended ◦ the reported adverse medical effects of steroid

use, such as potential liver damage and endocrinological problems, were not really relevant to the criteria for scheduling under the Controlled Substances Act

added anabolic steroids as Schedule III controlled substances criminalizing non-medical use

It places steroids in the same legal class as barbiturates, ketamine and LSD precursors.