 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 1 st pass metabolism  Risk for liver

 Promote increased muscle mass and enhance physical strength  Increase endurance, physical appearance, and athletic performance  ◦ previously undetectable anabolic steroid tetrahydrogestrinione incited furor in media when high prof ◦ High profile professional athletes admitted to using this drug.  March ◦ 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 ) 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.