30 MD musculardevelopment.com July 2019
BY GEORGE TOULIATOS, MD
The speculated ‘roid rage deals with the consequences
of performance-enhancing drugs (PEDs) and androgenic-
anabolic steroids (AAS) abuse in the mental status and
psychology of bodybuilders. The psychopathological aspect
of PEDs/AAS neurotoxicity and dependence can present as a
chronic, long-term adverse eff ect, or in the form of episodes-
crisis adverse eff ect.
Apart from the fact that bodybuilders have an external
appearance way freakier that the average individual, the
combination of an extreme low-carbohydrate, low-caloric diet,
along with exhausting training with chemical enhancement
abuse, would create an explosive combination, leading
eventually to psychopathologic behavior.
‘Roid rage has been associated with various psychiatric
manifestations such as sleep disorders (insomnia), anxiety
(restlessness), mania, depression, irritability , aggression,
violence, suicidal behavior, psychosis (misconceptions),
confusion and delirium. These side eff ects are correlated
to the degree of abuse in terms of dosage and time period.
Furthermore, long-term abuse may lead to the development of a
dependence syndrome and withdrawal symptoms on cessation.
AAS readily pass through the blood-brain barrier and aff ect
central nervous system function. Androgen receptors (AR) are
abundantly expressed in the limbic system of the amygdale
and hippocampus, brain stem, hypothalamus (master gland)
and cerebral cortex, implicating a wide range of functions,
including regulation of emotion and cognition. Androgen receptors
correspond to diff erent chemical substances that are able to
cross the blood-brain barrier (17-beta-trenbolone). As a result,
some anabolic steroids with a high level of androgenicity , for
instance fl uoxymesterone (800 androgenic index) or trenbolone
(500 androgenic index), have the ability to bind tighter to the
AR. It has being demonstrated that neural junctions transmit
signals much faster, refl ecting directly to serotonin, dopamine
neurotransmitt ers metabolism. However, this is not exclusively
linked to the androgenic activity of a particular AAS. Nandrolone
decanoate has been associated with several behavioral disorders
in supraphysiological treatment doses (>200mg/15 days).
Experimental and animal studies strongly suggest that
apoptotic mechanisms are at least in part involved in AAS-
induced neurotoxicity. Furthermore, a great body of evidence is
suggesting that increased cellular oxidative stress to cerebral
neurons could play a major role in the pathogenesis of many
neurodegenerative disorders, such as manic depression
or bipolar eff ect. In another study, 17-beta-trenbolone was
administered to adult and pregnant rats and induced apoptosis
of primary hippocampal neurons. The hippocampus is a
ANDROGEN EMOTIONAL
TOXICITY SYNDROME
‘Roid rage has been associated with various psychiatric
manifestations such as sleep disorders (insomnia),
anxiety (restlessness), mania, depression, irritability,
aggression, violence, suicidal behavior, psychosis
(misconceptions), confusion and delirium.