Neuropsychiatric effects of anabolic steroids in male normal volunteers

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Abstract
Objective.\p=m-\To evaluate the acute effects of anabolic steroids on mood and be- havior in male normal volunteers. Design.\p=m-\A2-week, double-blind (subject and rater), fixed-order, placebo\x=req-\ controlled crossover trial of methyltestosterone. Setting.\p=m-\Aninpatient research unit at the National Institutes of Health. Subjects.\p=m-\Avolunteer sample of 20 men who were medication free, free of medical and psychiatric illness, not involved in athletic training, and had no prior history of anabolic steroid use. Intervention.\p=m-\Asequential trial for 3 days each of the following four drug con- ditions: placebo baseline, low-dose methyltestosterone (40 mg/d), high-dose me- thyltestosterone (240 mg/d), and placebo withdrawal. Main Outcome Measures.\p=m-\Moodand behavioral ratings were completed dur- ing each drug condition and included both subjective and objective measures. Results.\p=m-\Significant(P<.05) albeit subtle increases in symptom scores were observed during high-dose methyltestosterone administration compared with baseline in positive mood (euphoria, energy, and sexual arousal), negative mood (irritability, mood swings, violent feelings, and hostility), and cognitive impairment (distractibility, forgetfulness, and confusion). An acute manic episode was observed in one of the 20 subjects, representing a 5% incidence, even under these conser- vative conditions. An additional subject became hypomanic. Baseline characteris- tics including family psychiatric history or previous drug abuse did not predict symptom changes. Conclusion.\p=m-\Thisis the first placebo-controlled prospective study demonstrat- ing the adverse and activating mood and behavioral effects of anabolic steroids. (JAMA. 1993;269:2760-2764)

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