Steroids, psychosis and poly-substance abuse

Area of Science:

• Endocrinology
• Psychiatry
• Forensic Medicine

Background:

• Non-medical anabolic-androgenic steroid (AAS) use is a growing public health concern.
• The demographic profile of AAS users is shifting, leading to increased poly-substance misuse.
• This shift potentially exacerbates the associated medical, psychiatric, and forensic risks.

Purpose of the Study:

• To review the consequences of the changing demographic profile of anabolic-androgenic steroid (AAS) use.
• To highlight the medical and psychiatric side effects associated with AAS misuse.
• To underscore the need for increased awareness among medical professionals regarding AAS-related risks.

Main Methods:

• Case report of a young male experiencing adverse effects from methandrostenolone use.
• Review of key literature pertaining to anabolic-androgenic steroid (AAS) use and its consequences.

Main Results:

• A case of a 19-year-old male presenting with rhabdomyolysis and a psychotic episode with homicidal ideation following methandrostenolone use.
• The individual had a history of cannabis use but no prior psychotic symptoms, indicating AAS as a potential trigger.
• Poly-substance misuse, including cannabis and AAS, can amplify the severity of adverse effects.

Conclusions:

• A higher index of suspicion for anabolic-androgenic steroid (AAS) use is crucial for medical practitioners.
• Medical personnel must be aware of potential side effects, including psychiatric disturbances and increased risk of violence.
• Further research is necessary to determine the prevalence and specific risks of AAS use in Ireland.