anabolic steroids and hallucinations

   Anabolic steroids are also known as anabolic-androgenic steroids, or AASs for short. In popular parlance, the group of anabolic steroids is sometimes referred to as 'steroids'. The term anabolic steroid can be traced to the Greek verb anaballein (to toss in the air), the name sterol (i.e. a compound of cholesterol), and the word ending -oid. It is used to denote a class of "steroids that interact with androgen receptors and that play a role in the stimulation of muscle and bone synthesis. AASs are chemically related to testosterone. They are classified as either endogenous (i.e. 'natural') or exogenous (i.e. synthetic) in nature. Endogenous AASs have a function in the development and maintenance of masculine body characteristics such as muscle bulk and secondary sex characteristics. Exogenous AASs are used in biomedicine for the build-up of cellular tissue in muscles. In sport, they are used for aesthetic and performance-related purposes. Athletes sometimes use AASs in doses of up to 100 times the recommended therapeutic dose. In their current form, AASs were used for the first time by German soldiers during World War II in an attempt to increase strength, endurance, and combativeness. The simultaneous use of multiple oral and/or injectable preparations is known as 'stacking'. The use of exogenous AASs in so-called supra-pharmacological doses - as well as the withdrawal from such doses - is notorious for the many adverse physical and psychological effects. The possible physical side effects include benign and malignant liver tumours, testicu-lar atrophy, gynaecomastia, hypertension, and metabolic disorders such as abnormal glucose tolerance and hypercholesterolaemia. Among the psychological side effects are euphoria, hypo-mania, mania, anxiety, low self-esteem, depression, fatigue, delusions of grandiosity, paranoia, paranoid delusions, and a syndrome nicknamed 'roid rage', which is characterized by an increase in irritability, aggressiveness, and physically violent behaviour. Yet another complication of the use of AASs is "steroid psychosis, a condition characterized by a variety of symptoms, such as attention deficits, memory impairment, formal thought disorder, insomnia, euphoria, hypo-mania, anxiety, depression, agitation, mutism, paranoia, delusions, "hyperacusis, "body schema illusions, "Gedankenlautwerden,and "auditory as well as " visual hallucinations. After the cessation of steroid use, spontaneous remittance may take 2 weeks to 7 months, with 80% of the cases reported in the literature having remitted by the sixth week. The administration of antipsychotics tends to shorten the remittance period significantly. The duration of steroid-induced "delirium is usually shorter. After the cessation of steroid administration, delirious states are reported to abate within 1 week. However, steroid psychosis and delirium occasionally develop into prolonged and/or recurrent psychotic states indistinguishable from those in individuals with a clinical diagnosis of " schizophrenia.

   References

   Pope, H.G., Katz, D.L. (1988). Affective and psychotic symptoms associated with anabolic steroid use. American Journal of Psychiatry, 145, 487-490.

   Williamson, D.J., Young, A.H. (1992). Psychiatric effects of androgenic and anabolic-androgenic steroid abuse in men: A brief review of the literature. Journal of Psychophar-macology, 6, 20-26.