Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review

<i>Background and Objectives:</i> Anabolic androgenic steroids (AASs) are a complex group of molecules that include both steroidal androgens and synthetic compounds, derived from testosterone. AASs are commonly used to support pharmacological therapy in cases of primary or secondary hypo...

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Main Authors: Giuseppe Bertozzi, Monica Salerno, Cristoforo Pomara, Francesco Sessa
Format: Article
Language:English
Published: MDPI AG 2019-07-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1010-660X/55/7/396
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author Giuseppe Bertozzi
Monica Salerno
Cristoforo Pomara
Francesco Sessa
author_facet Giuseppe Bertozzi
Monica Salerno
Cristoforo Pomara
Francesco Sessa
author_sort Giuseppe Bertozzi
collection DOAJ
description <i>Background and Objectives:</i> Anabolic androgenic steroids (AASs) are a complex group of molecules that include both steroidal androgens and synthetic compounds, derived from testosterone. AASs are commonly used to support pharmacological therapy in cases of primary or secondary hypogonadism, major burns, and neoplastic cachexia. Their prolonged and supra-physiological consumption can provoke several adverse effects on various organs and systems. Among these, the physiopathological mechanisms that induce neuropsychiatric disorders related to AAS abuse are poorly known. For this reason, the proposed review aims to retrace the pathway of action of testosterone to focus on the effects on the central nervous system and specifically highlight the effects of AASs on neuropsychiatric and behavioral functions, as well as on lifestyle. <i>Materials and Methods:</i> This review was conducted using PubMed and Google Scholar databases. On these database websites, we searched for articles from 1 January 1980 to March 2019 using the key terms: &#8220;AAS,&#8221; &#8220;Anabolic Androgenic Steroids,&#8221; &#8220;brain,&#8221; and &#8220;neurology.&#8221; <i>Results:</i> The use of AASs through self-administration yields circulating androgens levels, inducing neuron apoptosis, which is linked to thinner cortex and, in general, less cortical volume. The same alterations affect the putamen. These differences were more evident when correlated with longer use. From a functional point of view, prolonged AAS consumption seemed to be related to lower connectivity between amygdala and frontal, striatal, limbic, hippocampal and visual cortical areas. On the other hand, AAS use seems to negatively condition the positive effects of the sport exercise, reducing its important anti-apoptotic and pro-proliferative functions on the hippocampus, implicated in anxiolytic control. <i>Conclusion:</i> This review clarifies the major aspects of the side effects related to AAS use/abuse highlighting the complex mechanisms on neuropsychiatric and cognitive pathological alterations and also the emotional and behavioral dysfunctions.
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spelling doaj.art-e0bcae09d36b4f4ba9296439fba7d4af2023-09-02T02:28:57ZengMDPI AGMedicina1010-660X2019-07-0155739610.3390/medicina55070396medicina55070396Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature ReviewGiuseppe Bertozzi0Monica Salerno1Cristoforo Pomara2Francesco Sessa3Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, ItalyDepartment of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, ItalyDepartment of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy<i>Background and Objectives:</i> Anabolic androgenic steroids (AASs) are a complex group of molecules that include both steroidal androgens and synthetic compounds, derived from testosterone. AASs are commonly used to support pharmacological therapy in cases of primary or secondary hypogonadism, major burns, and neoplastic cachexia. Their prolonged and supra-physiological consumption can provoke several adverse effects on various organs and systems. Among these, the physiopathological mechanisms that induce neuropsychiatric disorders related to AAS abuse are poorly known. For this reason, the proposed review aims to retrace the pathway of action of testosterone to focus on the effects on the central nervous system and specifically highlight the effects of AASs on neuropsychiatric and behavioral functions, as well as on lifestyle. <i>Materials and Methods:</i> This review was conducted using PubMed and Google Scholar databases. On these database websites, we searched for articles from 1 January 1980 to March 2019 using the key terms: &#8220;AAS,&#8221; &#8220;Anabolic Androgenic Steroids,&#8221; &#8220;brain,&#8221; and &#8220;neurology.&#8221; <i>Results:</i> The use of AASs through self-administration yields circulating androgens levels, inducing neuron apoptosis, which is linked to thinner cortex and, in general, less cortical volume. The same alterations affect the putamen. These differences were more evident when correlated with longer use. From a functional point of view, prolonged AAS consumption seemed to be related to lower connectivity between amygdala and frontal, striatal, limbic, hippocampal and visual cortical areas. On the other hand, AAS use seems to negatively condition the positive effects of the sport exercise, reducing its important anti-apoptotic and pro-proliferative functions on the hippocampus, implicated in anxiolytic control. <i>Conclusion:</i> This review clarifies the major aspects of the side effects related to AAS use/abuse highlighting the complex mechanisms on neuropsychiatric and cognitive pathological alterations and also the emotional and behavioral dysfunctions.https://www.mdpi.com/1010-660X/55/7/396anabolic androgenic steroidsside effectslifestyleneuropsychiatric manifestationsbehavior
spellingShingle Giuseppe Bertozzi
Monica Salerno
Cristoforo Pomara
Francesco Sessa
Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review
Medicina
anabolic androgenic steroids
side effects
lifestyle
neuropsychiatric manifestations
behavior
title Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review
title_full Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review
title_fullStr Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review
title_full_unstemmed Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review
title_short Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review
title_sort neuropsychiatric and behavioral involvement in aas abusers a literature review
topic anabolic androgenic steroids
side effects
lifestyle
neuropsychiatric manifestations
behavior
url https://www.mdpi.com/1010-660X/55/7/396
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AT monicasalerno neuropsychiatricandbehavioralinvolvementinaasabusersaliteraturereview
AT cristoforopomara neuropsychiatricandbehavioralinvolvementinaasabusersaliteraturereview
AT francescosessa neuropsychiatricandbehavioralinvolvementinaasabusersaliteraturereview