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.
Pharmacodynamics
Anabolic steroids bind to specific receptors
present especially in reproductive tissue, muscle and.
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.
that anabolic steroids enhance overall athletic
performance (Elashoff et al, 1991).
Main adverse effects
The adverse effects of anabolic steroids include weight.
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.
virilization.
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.
feature of long-term abuse of anabolic steroids, and
gynaecomastia can occur (Martikainen et al., 1986;
Schurmeyer et al., 1984; Spano & Ryan, 1984).
.
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.
After administration of radiolabelled testosterone,
about 90% of the radioactivity appears in the urine, and 6%
in the faeces; there is some enterohepatic recirculation.
(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.
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.
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..
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.
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..
A 19-year old American college footballer took intramuscular
testosterone and oral methandrostenolone over 4 months. He.
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.
months (Schulte et al, 1993).
Specific preventive measures
Anabolic steroid abuse amongst athletes, weight.
lifters, body builders and others is now apparently common at
all levels of these sports. Not all abusers are competitive
sportsmen.
There is therefore scope for a public health campaign, for
example, based on gymnasia, to emphasize the dangers of.
anabolic steroid abuse and to support those who wish to stop
using the drugs.
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AUTHOR(S), REVIEWER(S), DATE(S) (INCLUDING UPDATES), COMPLETE.
ADDRESS(ES)
Author: Dr R. E. Ferner,
West Midlands Centre for Adverse Drug Reaction
Reporting,
City Hospital Dudley Road,.
Birmingham B18 7QH
England.
Tel: +44-121-5074587
Fax: +44-121-5236125
Email: fernerre@bham.ac.uk
Date: 1994.
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
.
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