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Roid rage

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Roid Rage
Illegal anabolic steroids from a raid by the Drug Enforcement Administration
SymptomsAggression, Violent tendencies, Emotional dysregulation (Anxiety, Depression), Psychosis[1]
TreatmentLimiting anabolic steroid use,[2] therapy,[3] Antipsychotics[4]

Roid rage (also known as steroid rage[5]) is a side effect of the use of anabolic steroids which is described as dramatic mood swings, increased feelings of hostility, impaired judgment, and increased levels of aggression.[6] The term "roid rage" became popular in the 1980s.[7]

Cause

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After supraphysiological use of anabolic-androgenic steroid which normally consists of long-term uncontrolled use of anabolic steroids (i.e. several injections over a period of time) roid rage can take place, which includes aggression[8][9] and emotional dysregulation which can lead to depression and paranoia.[10] Use of steroids like corticosteroid to treat pains can cause steroid induced psychotic episodes which include racing thoughts, anger, agitation, pressured hyperverbal speech and paranoia.[11]

Effects

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The effects of roid rage, which is not only seen in humans who take large doses of anabolic steroids but also when the same or even lower doses are administered to animals like lab rats, include the heavy increase in aggression and the fight-or-flight response. This was shown in study of lab rats where when the nucleus accumbens' and medial prefrontal cortex's tyrosine hydroxylase of a group of lab rats who were administered anabolic steroids showed no difference in tyrosine hydroxylase compared to regular lab rats but the caudate putamen, a brain area important for behavioral inhibition, motor control and habit learning, showed a significant decrease in tyrosine hydroxylase due to the testosterone.[12] Indecisiveness is linked to changes in the mesocorticolimbic dopamine system with anabolic steroids having an affect opamine function in mesocorticolimbic circuitry, there's no understanding how this specifically affects decision making exactly, this indecisiveness is shown in lab rats which then turns into aggression, i.e. roid rage.[13] Heavy signs of anxiety,[14] mania,[15] and paranoia were also present when "roid rage" becomes more present in the person taking in the anabolic steroids.[16] Psychopathy is heavily increased if a person has underlying disorders for it when roid rage is present, where research shows the connection between substance misuse/abuse of anabolic steroids to violence, repeated imprisonment, and disrespect for authority.[17]

Effects of roid rage have chances to be greatly increased in aggression and impulsiveness if the abuser of anabolic steroids has any underlying personality disorders like Borderline Personality Disorder.[18] Heavy use of anabolic steroids with roid rage can cause heavy distress as well depending on how long the steroids have been abused.[19]

During puberty (in adolescent males) the intake of anabolic steroids can alter mood and personality causing a heavier roid rage that can impact them for a long-term time range.[20] Due to puberty being a sensitive time period with hormones, anabolic steroids can cause a shift on testosterone production and induce unprovoked aggression whether the person may or may not still be using anabolic steroids.[21] This may lead to extreme violent tendencies even after a year of drug absence, which is more present in adolescents and young adults, anabolic steroids are link directly to the heightened factor of violent tendencies.[22]

After tests were done comparing the use of methyltestosterone and stanozolol (both compounds of anabolic steroids) on castrated lab rats, both showed levels of heightened aggression, which shows that if males had a vasectomy that it can still affect the levels of aggression they would have.[23]

Violence

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When a person is experiencing roid rage and increased levels of aggression, they may become easily provokable and be prone to commit violent assaults.[24] Many times when a person has abused anabolic steroids and commits violent crimes, they do not maintain the same levels of judgement to their actions, which may lead to aggravated murders.[25] The abuse of other drugs can lead to a worsening effects of aggression and violence that a person may commit.[26]

According to anecdotal reports, wives and girlfriends of athletes who take anabolic steroids face violence when the users of anabolic steroids continue to use them, this includes verbal abuse and physical domestic abuse.[27]

Treatment

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Certain drugs that minimise the amount of oestrogen created as the anabolic steroids break down could help lessen the aggression.[28] Anabolic steroid users can go into a psychosis when roid rage is induced, and even start experiencing suicidal ideation, some antipsychotic medications, such as haloperidol, have been used extensively to treat the psychosis induced roid rage, evidence also exists to support second-generation antipsychotics, lithium, selective serotonin reuptake inhibitors, tricyclic antidepressants (TCAs), and select antiepileptic drugs, including carbamazepine as well as valproic acid and its derivatives.[29]

[edit]

In a season 8 episode of South Park, Up the Down Steroid, the character Jimmy goes into a roid rage after use of anabolic steroids.[30]

In a season 7 episode of Family Guy, Stew-Roids, the character Stewie Griffin develops roid rage after his father Peter Griffin gives him steroids in order to make him stronger at the gym.[31]

References

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  1. ^ Rashid, Harry; Ormerod, Sara; Day, Ed (2007). "Anabolic androgenic steroids: what the psychiatrist needs to know". Advances in Psychiatric Treatment. 13 (3): 203–211. doi:10.1192/apt.bp.105.000935. ISSN 1355-5146.
  2. ^ Elliot, D.; Goldberg, L. (1996). "Intervention and prevention of steroid use in adolescents". The American Journal of Sports Medicine. 24 (6 Suppl): S46–47. doi:10.1177/036354659602406S14. ISSN 0363-5465. PMID 8947428.
  3. ^ Anawalt, Bradley D (2019-07-01). "Diagnosis and Management of Anabolic Androgenic Steroid Use". The Journal of Clinical Endocrinology and Metabolism. 104 (7): 2490–2500. doi:10.1210/jc.2018-01882. ISSN 0021-972X. PMC 6517163. PMID 30753550.
  4. ^ Romanova, Zuzana; Hlavacova, Natasa; Jezova, Daniela (2022-01-14). "Psychotropic Drug Effects on Steroid Stress Hormone Release and Possible Mechanisms Involved". International Journal of Molecular Sciences. 23 (2): 908. doi:10.3390/ijms23020908. ISSN 1422-0067. PMC 8779609. PMID 35055090.
  5. ^ Pope, HarrisonG.; Katz, DavidL. (1987). "Bodybuilder's Psychosis". The Lancet. 329 (8537): 863. doi:10.1016/S0140-6736(87)91642-4. PMID 2882266.
  6. ^ Mulube, M. (1996-09-21). "Personality changes due to "roid rage"". The BMJ. 313 (7059): 707. doi:10.1136/bmj.313.7059.707. ISSN 0959-8138.
  7. ^ Lenehan, Patrick (2003). Anabolic Steroids. Boca Raton: CRC Press LLC. p. 23. ISBN 978-0-415-28030-3.
  8. ^ Chegeni, Razieh; Pallesen, Ståle; McVeigh, Jim; Sagoe, Dominic (2021). "Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies". Psychopharmacology. 238 (7): 1911–1922. doi:10.1007/s00213-021-05818-7. ISSN 0033-3158. PMC 8233285. PMID 33745011.
  9. ^ Bertozzi, Giuseppe; Sessa, Francesco; Albano, Giuseppe Davide; Sani, Gabriele; Maglietta, Francesca; Roshan, Mohsin H. K.; Volti, Giovanni Li; Bernardini, Renato; Avola, Roberto; Pomara, Cristoforo; Salerno, Monica (2018). "The Role of Anabolic Androgenic Steroids in Disruption of the Physiological Function in Discrete Areas of the Central Nervous System". Molecular Neurobiology. 55 (7): 5548–5556. doi:10.1007/s12035-017-0774-1. ISSN 0893-7648. PMC 5994209. PMID 28971285.
  10. ^ Gonçalves-Pinho, M.; Quarenta, J.; Almeida, A. (2021). "P.0060 From roid rage to depression - a case report". European Neuropsychopharmacology. 53: S44. doi:10.1016/j.euroneuro.2021.10.065.
  11. ^ Benyamin, Ramsin M.; Vallejo, Ricardo; Kramer, Jeffery; Rafeyan, Roueen (2008). "Corticosteroid induced psychosis in the pain management setting". Pain Physician. 11 (6): 917–920. doi:10.36076/ppj.2008/11/917. ISSN 1533-3159. PMID 19057637.
  12. ^ Wood, Ruth I.; Armstrong, Abigail; Fridkin, Vlad; Shah, Vivek; Najafi, Allison; Jakowec, Michael (2013). "'Roid rage in rats? Testosterone effects on aggressive motivation, impulsivity and tyrosine hydroxylase". Physiology & Behavior. 110–111: 6–12. doi:10.1016/j.physbeh.2012.12.005. PMC 3615053. PMID 23266798.
  13. ^ Wallin, Kathryn G.; Alves, Jasmin M.; Wood, Ruth I. (2015). "Anabolic–androgenic steroids and decision making: Probability and effort discounting in male rats". Psychoneuroendocrinology. 57: 84–92. doi:10.1016/j.psyneuen.2015.03.023. PMC 4437834. PMID 25900595.
  14. ^ Sanjuan, Pilar M.; Langenbucher, James L.; Hildebrandt, Tom (2016-07-03). "Mood symptoms in steroid users: the unexamined role of concurrent stimulant use". Journal of Substance Use. 21 (4): 395–399. doi:10.3109/14659891.2015.1040089. ISSN 1465-9891. PMC 4979577. PMID 27524938.
  15. ^ Cooke, Robert G.; Krüger, Stephanie; Shugar, Gerald (1996). "Comparative evaluation of two self-report mania rating scales". Biological Psychiatry. 40 (4): 279–283. doi:10.1016/0006-3223(95)00392-4. PMID 8871774.
  16. ^ Mhillaj, Emanuela; Morgese, Maria G.; Tucci, Paolo; Bove, Maria; Schiavone, Stefania; Trabace, Luigia (2015-08-26). "Effects of anabolic-androgens on brain reward function". Frontiers in Neuroscience. 9: 295. doi:10.3389/fnins.2015.00295. ISSN 1662-453X. PMC 4549565. PMID 26379484.
  17. ^ Nelson, Bryan S.; Hildebrandt, Tom; Wallisch, Pascal (2022-06-01). "Anabolic–androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems". Scientific Reports. 12 (1): 9133. Bibcode:2022NatSR..12.9133N. doi:10.1038/s41598-022-13048-w. ISSN 2045-2322. PMC 9160254. PMID 35650220.
  18. ^ Schaive, Chad; Tobias S. Kohler, Tobias S. x (2016). "An inside perspective on anabolic steroid abuse". Translational Andrology and Urology. 5 (2): 220–224. doi:10.21037/tau.2016.03.08. PMC 4837320. PMID 27141450.
  19. ^ Chegeni, Razieh; Notelaers, Guy; Pallesen, Ståle; Sagoe, Dominic (2021-06-04). "Aggression and Psychological Distress in Male and Female Anabolic-Androgenic Steroid Users: A Multigroup Latent Class Analysis". Frontiers in Psychiatry. 12. doi:10.3389/fpsyt.2021.629428. ISSN 1664-0640. PMC 8211877. PMID 34149470.
  20. ^ Lumia, Augustus R.; McGinnis, Marilyn Y. (2010). "Impact of anabolic androgenic steroids on adolescent males". Physiology & Behavior. 100 (3): 199–204. doi:10.1016/j.physbeh.2010.01.007. PMID 20096713.
  21. ^ Batrinos, Menelaos L. (2012-06-01). "Testosterone and aggressive behavior in man". International Journal of Endocrinology & Metabolism. 10 (3): 563–568. doi:10.5812/ijem.3661. PMC 3693622. PMID 23843821.
  22. ^ Beaver, Kevin M.; Vaughn, Michael G.; DeLisi, Matt; Wright, John Paul (2011-09-20). "Anabolic-Androgenic Steroid Use and Involvement in Violent Behavior in a Nationally Representative Sample of Young Adult Males in the United States". American Journal of Public Health. 98 (12): 2185–2187. doi:10.2105/AJPH.2008.137018. ISSN 0090-0036. PMC 2636528. PMID 18923108.
  23. ^ Clark, Ann S.; Barber, Diana M. (1994). "Anabolic-androgenic steroids and aggression in castrated male rats". Physiology & Behavior. 56 (5): 1107–1113. doi:10.1016/0031-9384(94)90351-4. PMID 7824579.
  24. ^ Piacentino, Daria; Kotzalidis, Georgios; Casale, Antonio; Aromatario, Maria; Pomara, Cristoforo; Girardi, Paolo; Sani, Gabriele (2015-04-13). "Anabolic-androgenic Steroid use and Psychopathology in Athletes. A Systematic Review". Current Neuropharmacology. 13 (1): 101–121. doi:10.2174/1570159x13666141210222725. ISSN 1570-159X. PMC 4462035. PMID 26074746.
  25. ^ Pope, Harrison G.; Kanayama, Gen; Hudson, James I.; Kaufman, Marc J. (2021). "Review Article: Anabolic-Androgenic Steroids, Violence, and Crime: Two Cases and Literature Review". The American Journal on Addictions. 30 (5): 423–432. doi:10.1111/ajad.13157. ISSN 1055-0496. PMC 8995103. PMID 33870584.
  26. ^ Klötz, Fia; Petersson, Anna; Isacson, Dag; Thiblin, Ingemar (2007). "Violent crime and substance abuse: A medico-legal comparison between deceased users of anabolic androgenic steroids and abusers of illicit drugs". Forensic Science International. 173 (1): 57–63. doi:10.1016/j.forsciint.2007.01.026. PMID 17337333.
  27. ^ Choi, Precilla; Pope, Harrison (1994-03-01). "Violence Toward Women and Illicit Androgenic-Anabolic Steroid Use". Annals of Clinical Psychiatry. 6 (1): 21–25. doi:10.3109/10401239409148835. ISSN 1040-1237. PMID 7951641.
  28. ^ Hamzelou, Jessica (2011-04-09). "Should steroid users be given drugs to treat 'roid rage'?". New Scientist. 210 (2807): 12. Bibcode:2011NewSc.210...12H. doi:10.1016/S0262-4079(11)60777-X.
  29. ^ Huynh, Grace; Reinert, Justin P. (2021). "Pharmacological Management of Steroid-Induced Psychosis: A Review of Patient Cases". Journal of Pharmacy Technology. 37 (2): 120–126. doi:10.1177/8755122520978534. ISSN 8755-1225. PMC 7953074. PMID 34752563.
  30. ^ Schorn, Peter (August 26, 2006). "South Park: The Complete Eighth Season DVD Review". IGN. Retrieved April 25, 2017.
  31. ^ "Family Guy – Stew-Roids". Yahoo! TV. Retrieved September 29, 2012.
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