Neuropsychiatric Effects of Anabolic Steroids in Male Normal Volunteers

OBJECTIVE: To evaluate the acute effects of anabolic steroids on mood and behavior in male normal volunteers. DESIGN: A 2-week, double-blind (subject and rater), fixed-order, placebo-controlled crossover trial of methyltestosterone. SETTING: An inpatient research unit at the National Institutes of Health. SUBJECTS: A volunteer sample of 20 men who were medication free, free of medical and psychiatric illness, not involved in athletic training, and had no prior history of anabolic steroid use. INTERVENTION: A sequential trial for 3 days each of the following four drug conditions: placebo baseline, low-dose methyltestosterone (40 mg/d), high-dose methyltestosterone (240 mg/d), and placebo withdrawal. MAIN OUTCOME MEASURES: Mood and behavioral ratings were completed during each drug condition and included both subjective and objective measures. RESULTS: Significant (P < .05) albeit subtle increases in symptom scores were observed during high-dose methyltestosterone administration compared with baseline in positive mood (euphoria, energy, and sexual arousal), negative mood (irritability, mood swings, violent feelings, and hostility), and cognitive impairment (distractibility, forgetfulness, and confusion). An acute manic episode was observed in one of the 20 subjects, representing a 5% incidence, even under these conservative conditions. An additional subject became hypomanic. Baseline characteristics including family psychiatric history or previous drug abuse did not predict symptom changes. CONCLUSION: This is the first placebo-controlled prospective study demonstrating the adverse and activating mood and behavioral effects of anabolic steroids.