A 22-year old body builder took two eight-week courses of
anabolic steroids. He became severely depressed after the
second course, and when the depression gradually receded, he
had prominent paranoid and religious delusions
(Pope and Katz, 1987).

In the previous chapter we saw important dangers and genuine uses of Methandienone.
There is more to it.


Anabolic steroids bind to specific receptors
present especially in reproductive tissue, muscle and.To Top of the Post
fat (Mooradian & Morley, 1987). The anabolic steroids
reduce nitrogen excretion from tissue breakdown in
androgen deficient men. They are also responsible for
normal male sexual differentiation. The ratio of
anabolic ("body-building") effects to androgenic
(virilizing) effects may differ among the members of
the class, but in practice all agents possess both
properties to some degree. There is no clear evidence.To Top of the Post
that anabolic steroids enhance overall athletic
performance (Elashoff et al, 1991).
Main adverse effects

The adverse effects of anabolic steroids include weight.To Top of the Post
gain, fluid retention, and abnormal liver function as
measured by biochemical tests. Administration to children can
cause premature closure of the epiphyses. Men can develop
impotence and azoospermia. Women are at risk of.To Top of the Post
Endocrine and reproductive systems

Small doses of anabolic steroids are said to
increase libido, but larger doses lead to azoospermia
and impotence. Testicular atrophy is a common clinical.To Top of the Post
feature of long-term abuse of anabolic steroids, and
gynaecomastia can occur
(Martikainen et al., 1986;
Schurmeyer et al., 1984; Spano & Ryan, 1984).
.To Top of the Post
Women develop signs of virilism, with increased facial
hair, male pattern baldness, acne, deepening of the
voice, irregular menses and clitoral enlargement

(Malarkey et al., 1991; Strauss et al., 1984).

Elimination by route of exposure.To Top of the Post

After administration of radiolabelled testosterone,
about 90% of the radioactivity appears in the urine, and 6%
in the faeces; there is some enterohepatic recirculation.To Top of the Post
(Wilson, 1992).

Distribution by route of exposure

The anabolic steroids are highly protein bound, and is
carried in plasma by a specific protein called sex-hormone.To Top of the Post
binding globulin.
The metabolism of absorbed drug is rapid, and the
elimination half-life from plasma is very short. The duration
of the biological effects is therefore determined almost.To Top of the Post
entirely by the rate of absorption from subcutaneous or
intramuscular depots, and on the de-esterification which
precedes it (Wilson, 1992).
Case reports from literature

A 38-year old man presented with acute urinary
retention, and was found to have carcinoma of the prostate..To Top of the Post
He had taken anabolic steroids for many years, and worked as
a "strong-man" (Roberts and Essenhigh, 1986).

A 22-year old male world-class weight lifter developed severe
chest pain awaking him from sleep, and was shown to have.To Top of the Post
myocardial infarction. For six weeks before, he had been
taking high doses of oral and injected anabolic steroids.
Total serum cholesterol was 596 mg/dL (HDL 14 mg/dL, LDL 513
mg/dL) (McNutt et al., 1988). Values of total cholesterol
concentration above 200 mg/dL are considered undesirable..To Top of the Post

A 19-year old American college footballer took intramuscular
testosterone and oral methandrostenolone over 4 months. He.To Top of the Post
became increasingly aggressive with his wife and child. After
he severely injured the child, he ceased using anabolic
steroids, and his violence and aggression resolved within 2.To Top of the Post
months (Schulte et al, 1993).

Specific preventive measures

Anabolic steroid abuse amongst athletes, weight.To Top of the Post
lifters, body builders and others is now apparently common at
all levels of these sports. Not all abusers are competitive
There is therefore scope for a public health campaign, for
example, based on gymnasia, to emphasize the dangers of.To Top of the Post
anabolic steroid abuse and to support those who wish to stop
using the drugs.

REFERENCES.To Top of the Post

ABPI Data Sheet Compendium (1993) Datapharm Publications,

Bowman S. (1990) Anabolic steroids and infarction. Br Med J;.To Top of the Post

Cohen JC & Hickman R. (1987) Insulin Resistance and diminished
glucose tolerance in powerlifters ingesting anabolic steroids. J
Clin Endocrinol Metab 64: 960.
.To Top of the Post
Cohen JC, Noakes TD, & Spinnler Benade AJ. (1988)
Hypercholesterolemia in male power lifters using Anabolic
Androgenic Steroids. The Physician and Sports medicine 16:
.To Top of the Post
Dalby JT. (1992) Brief anabolic steroid use and sustained
behavioral reaction. Am J Psychiatry 149: 271-272.

Dewhurst J. & Gordon RR (1984). Fertility following change of
sex: a follow-up. Lancet: ii: 1461-2.
.To Top of the Post
Elashoff JD, Jacknow AD, Shain SG, & Braunstein GD. (1991) Effects
of anabolic-androgenic steroids on muscular strength. Annals Inter
Med 115: 387-393..To Top of the Post

Falk H, Thomas LB, Popper H, Ishak KG. (1979). Hepatic
angiosacroma associated with androgenic-anabolic steroids. Lancet
2; 1120-1123.
.To Top of the Post
Ferner RE & Rawlins MD (1988) Anabolic steroids: the power and the
glory? Br Med J 1988; 297: 877-878.

Frankle MA, Eichberg R, & Zacharian SB. (1988) Anabolic Androgenic
steroids and stroke in an athlete: case report. Arch Phys Med
Rehabil 1988; 69: 632-633..To Top of the Post

Glazer G. (1991) Atherogenic effects of anabolic steroids on serum
lipid levels. Arch Intern Med 151: 1925-1933..To Top of the Post

Kennedy MC. (1992). Anabolic steroid abuse and toxicology. Aust NZ
J Med 22: 374-381.

Malarkey WB, Strauss RH, Leizman DJ, Liggett M, & Demers LM.
(1991). Endocrine effects in femal weight lifters who self-
administer testosterone and anabolic steroids. Am J Obstet.To Top of the Post
Gynecol 165: 1385-1390.

Martikainen H, Alen M, Rahkila P, & Vihko R. (1986) Testicular
responsiveness to human chorionic gonadotrophin during transient
hypogonadotrophic hypogondasim induced by androgenic/anabolic.To Top of the Post
steroids in power athletes. Biochem 25: 109-112.

McKillop G, Todd IC, Ballantyne D. (1986) Increased left
ventricular mass in a body builder using anabolic steroids. Brit J
Sports Med 20: 151-152.

McNutt RA, Ferenchick GS, Kirlin PC, & Hamlin NJ. (1988) Acute
myocardial infarction in a 22 year old world class weight lifter
using anabolic steroids. Am J Cardiol 62: 164..To Top of the Post

Mooradian JE, Morley JE, Korenman SG. (1987) Biological actions
of androgens. Endocrine Reviews 8:1-27.

Murad F, & Haynes RC. (1985). Androgens. in. Ed: Goodman Gilman
A, Goodman L S, Roll T W, Murad F. The Pharmacological Basis of
Therapeutics, 7th edition, Macmillan, New York: 1440-1458.To Top of the Post

Overly WL et al. (1984). Androgens and hepatocellular carcinoma in
an athlete. Ann Int Med 100: 158-159.

Pope GR, & Katz DL. (1988). Affective and psychotic symptoms
associated with anabolic steroid use. Am J Psychiatry 145:.To Top of the Post

Reynolds Ed. (1992) Martindale-The Extra Pharmacopeia. The
Pharmaceutical Press. London.

Roberts JT, & Essenhigh DM. (1986) Adenocarcinoma of prostate in
40-year old body builder. Lancet 2: 742.

Ross RB, & Deutsch S I.(1990) Hooked on hormones. JAMA 263:.To Top of the Post

Ryan A J. (1981) Anabolic steroids are fool's gold. Fed Proc 40:

Schurmeyer T, Belkien L, Knuth UA, & Nieschlag E. (1984).To Top of the Post
Reversible azoospermia induced by the anabolic steroid
19-nortestosterone. Lancet i: 417-420.

Soe KL. Soe M. & Gluud C. (1992). Liver pathology associated
with the use of anabolic-androgenic steroids. Liver 12:

Schulte HM, Hall MJ, & Boyer M. (1993). Domestic violence.To Top of the Post
associated with anabolic steroid abuse. Am J Psychiatr 150:

Spano F, & Ryan W G. (1989) Tamoxifen for gynecomastia induced by
anabolic steroids? New Engl J Med 311: 861-862.

Strauss RH, Liggett MT, & Lanese RR. (1984) Anabolic steroid use
and perceived effects in 10 weight-trained women athletes JAMA.To Top of the Post
253: 2871-2873.

Su T-P, Pagliaro M, Schmidt PJ, Pickar D, Wolkowitz O, & Rubinow
DR. (1993) Neuropsychiatric effects of anabolic steroids in male
normal volunteers. JAMA 269: 2760-2764.

Wagner JC (1989). Abuse of drugs used to enhance athletic.To Top of the Post
performance. Am J Hosp Pharm 46: 2059-2067

Webb O L, Laskarzewski P M, & Glueck, CJ. (1984) Severe depression
of high-density lipo protein cholesterol levels in weight lifters
and body builders by self-administered exogenous testerone and.To Top of the Post
anabolic-andorgenic steroids. Metabolism 33: 971-975.

Wilson J D. (1992). Androgens. In: Goodman Gilman A., Rall T W,
Nies A S, & Taylor P. Goodman and Gilman's Pharmacological Basis
of Therapeutics. McGraw-Hill, Toronto. Pages 1413-1430.


Author: Dr R. E. Ferner,
West Midlands Centre for Adverse Drug Reaction
City Hospital Dudley Road,.To Top of the Post
Birmingham B18 7QH
Tel: +44-121-5074587
Fax: +44-121-5236125

Date: 1994.To Top of the Post

Peer review: INTOX Meeting, Sao Paulo, Brazil, September 1994
(Drs P.Kulling, R.McKuowen, A.Borges, R.Higa,
R.Garnier, Hartigan-Go, E.Wickstrom)

Editor: Dr M.Ruse, March 1998
.To Top of the Post

TOPICS A - to - Z


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