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Metabolic & Cardiometabolic

anabolic-androgenic steroids increases aggression and anxiety

In plain terms: Do anabolic steroids increase aggression and anxiety?

Contested Metabolic & Cardiometabolic 🔬 Includes disconfirming

Part of: 💊 anabolic-androgenic steroids

RefutedContestedStrong support
consensus score 0.16

Only partly — controlled testosterone trials find increased aggression/anxiety in a minority at high doses, not uniformly; the blanket 'roid rage' framing runs ahead of the controlled evidence, even though heavy real-world abuse is linked to mood problems.

Evidence ladder

How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."

Top evidence so far: Population patterns (Observational)

MechanismIn-vitroAnimalObservationalRCTMeta-analysis

How the studies fall

4 support 0 contradict 2 tested null 4 mixed · 10 sources, 4 independent groups

The evidence (10)

SourceGradeStanceQualityFinding
Santos
2024 · Saudi Pharm J
animal supports low AAS increased aggression and neuroinflammation in female rodents and were linked to mood changes and psychiatric disorders in women.
Lieberman
2024 · Psychopharmacology
RCT mixed moderate Testosterone enanthate during energy deprivation had limited and inconsistent effects on aggression, risk-taking and mood.
Panagiotidis
2017 · Eur Neuropsychopharmacol
RCT mixed moderate Exogenous testosterone potentiated provocation-related anger but did not increase actual aggressive behavior.
Mhillaj
2015 · Front Neurosci
animal supports low Preclinical and clinical review links supratherapeutic AAS to anxiety, aggression and irritability via reward-system and neurotransmitter changes.
Tricker
1996 · J Clin Endocrinol Metab
RCT tested-null high 600 mg/week testosterone enanthate for 10 weeks produced no significant increase in anger or mood measures by self or observer report.
Bahrke
1996 · Sports Med
observational mixed moderate Update found associations between high-dose AAS and aggression/affective syndromes but only in a small percentage, with major methodological limitations.
Vorona
2018 · Minerva Endocrinol
observational supports moderate Review reports increased irritability, depressive mood and, in abusers, persistent anxiety and depression associated with AAS use.
Cueva
2017 · Horm Behav
RCT tested-null moderate 48-hour testosterone administration did not affect ultimatum-game rejections or aggressive mood in healthy men.
Talih
2007 · Cleve Clin J Med
observational supports low Review describes AAS abuse as associated with mania, aggression and depression, with withdrawal-related psychiatric symptoms.
Pope
2000 · Arch Gen Psychiatry
RCT mixed high Supraphysiologic testosterone produced significant manic/aggressive responses in a minority of men, with most showing little change (marked individual variability).

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