Roid rage (also known as steroid rage) is a

side effect In medicine, a side effect is an effect of the use of a medicinal drug or other treatment, usually adverse but sometimes beneficial, that is unintended. Herbal and traditional medicines also have side effects. A drug or procedure usually use ...

of the use of

anabolic steroids Anabolic steroids, also known as anabolic-androgenic steroids (AAS), are a class of drugs that are structurally related to testosterone, the main male sex hormone, and produce effects by binding to the androgen receptor (AR). Anabolic steroids ...

which is described as dramatic

mood swing A mood swing is an extreme or sudden change of mood. Such changes can play a positive or a disruptive part in promoting problem solving and in producing flexible forward planning. When mood swings are severe, they may be categorized as part ...

s, increased feelings of hostility, impaired judgment, and increased levels of

aggression Aggression is behavior aimed at opposing or attacking something or someone. Though often done with the intent to cause harm, some might channel it into creative and practical outlets. It may occur either reactively or without provocation. In h ...

. The term "roid rage" became popular in the 1980s.

Cause

After supraphysiological use of

anabolic Anabolism () is the set of metabolic pathways that construct macromolecules like DNA or RNA from smaller units. These reactions require energy, known also as an endergonic process. Anabolism is the building-up aspect of metabolism, whereas catab ...

androgen An androgen (from Greek ''andr-'', the stem of the word meaning ) is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This includes ...

steroid A steroid is an organic compound with four fused compound, fused rings (designated A, B, C, and D) arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes t ...

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 and

emotional dysregulation Emotional dysregulation is characterized by an inability to flexibly respond to and manage emotional states, resulting in intense and prolonged emotional reactions that deviate from social norms, given the nature of the environmental stimuli enc ...

which can lead to depression and

paranoia Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of co ...

. Use of steroids like

corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invo ...

to treat pains can cause steroid induced psychotic episodes which include

racing thoughts Racing thoughts refers to the rapid thought patterns that often occur in manic, hypomanic, or mixed episodes. While racing thoughts are most commonly described in people with bipolar disorder and sleep apnea, they are also common with anxiety dis ...

, anger, agitation, pressured hyperverbal speech and paranoia.

Effects

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 The fight-or-flight or the fight-flight-freeze-or-fawn (also called hyperarousal or the acute stress response) is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. It was first describ ...

. This was shown in study of lab rats where when the

nucleus accumbens The nucleus accumbens (NAc or NAcc; also known as the accumbens nucleus, or formerly as the ''nucleus accumbens septi'', Latin for ' nucleus adjacent to the septum') is a region in the basal forebrain rostral to the preoptic area of the hypo ...

and

medial prefrontal cortex In mammalian brain anatomy, the prefrontal cortex (PFC) covers the front part of the frontal lobe of the cerebral cortex. It is the association cortex in the frontal lobe. The PFC contains the Brodmann areas BA8, BA9, BA10, BA11, BA12, BA ...

of a group of lab rats who were administered anabolic steroids showed no difference in

tyrosine hydroxylase Tyrosine hydroxylase or tyrosine 3-monooxygenase is the enzyme responsible for catalyzing the conversion of the amino acid L-tyrosine to L-3,4-dihydroxyphenylalanine (L-DOPA). It does so using molecular oxygen (O2), as well as iron (Fe2+) and ...

compared to regular lab rats but the

caudate putamen Caudate (Latin for "tail") may refer to: * Caudate nucleus * Caudate leaf shape * Caudate lobe of liver * Cauda equina * A salamander Salamanders are a group of amphibians typically characterized by their lizard-like appearance, with slend ...

, a brain area important for behavioral inhibition,

motor control Motor control is the regulation of movements in organisms that possess a nervous system. Motor control includes conscious voluntary movements, subconscious muscle memory and involuntary reflexes, as well as instinctual taxes. To control ...

and habit learning, showed a significant decrease in tyrosine hydroxylase due to the

testosterone Testosterone is the primary male sex hormone and androgen in Male, males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testicles and prostate, as well as promoting se ...

. Indecisiveness is linked to changes in the mesocorticolimbic dopamine system with anabolic steroids having an affect dopamine function in mesocorticolimbic circuitry. It is not understood how this specifically affects decision making exactly. This indecisiveness is shown in lab rats which then turns into aggression, i.e. roid rage. Heavy signs of

anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...

mania Mania, also known as manic syndrome, is a Psychiatry, psychiatric Abnormality (behavior), behavioral syndrome defined as a state of Abnormality (behavior), abnormally elevated arousal, affect (psychology), affect, and energy level. During a mani ...

, and

were also present when "roid rage" becomes more present in the person taking in the anabolic steroids.

Psychopathy Psychopathy, or psychopathic personality, is a personality construct characterized by impaired empathy and remorse, along with bold, disinhibited, and egocentric traits. These traits are often masked by superficial charm and immunity ...

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. 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 such as

borderline personality disorder Borderline personality disorder (BPD) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, an acute fear of Abandonment (emotional), abandonment, and intense emotiona ...

. Heavy use of anabolic steroids with roid rage can cause heavy distress as well depending on how long the steroids have been abused. During

puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a female, the testicles i ...

(in

adolescent Adolescence () is a transitional stage of human physical and psychological development that generally occurs during the period from puberty to adulthood (typically corresponding to the age of majority). Adolescence is usually associated w ...

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. Due to puberty being a sensitive time period with

hormone A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physio ...

s, 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. This may lead to extreme violent tendencies even after a year of drug absence, which is more present in adolescents and

young adult In medicine and the social sciences, a young adult is generally a person in the years following adolescence, sometimes with some overlap. Definitions and opinions on what qualifies as a young adult vary, with works such as Erik Erikson's stages ...

s, anabolic steroids are linked directly to the heightened factor of violent tendencies. After tests were done comparing the use of

methyltestosterone Methyltestosterone, sold under the brand names Android, Metandren, and Testred among others, is an androgen and anabolic steroid (AAS) medication which is used in the treatment of low testosterone levels in men, delayed puberty in boys, at low ...

and

stanozolol Stanozolol (Abbreviation, abbrev. Stz), sold under many brand names, is a synthetic androgen and anabolic steroid (AAS) medication derived from dihydrotestosterone (DHT). It is used to treat hereditary angioedema. It was developed by American ph ...

(both compounds of anabolic steroids) on

castrated Castration is any action, surgical, chemical, or otherwise, by which a male loses use of the testicles: the male gonad. Surgical castration is bilateral orchiectomy (excision of both testicles), while chemical castration uses pharmaceutical ...

lab rats, both showed levels of heightened aggression, which shows that if males had a

vasectomy Vasectomy is an elective surgical procedure that results in male sterilization, often as a means of permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into ...

it can still affect the levels of aggression they would have.

Violence

When a person is experiencing roid rage and increased levels of aggression, they may become easily provokable and be prone to commit violent

assault In the terminology of law, an assault is the act of causing physical harm or consent, unwanted physical contact to another person, or, in some legal definitions, the threat or attempt to do so. It is both a crime and a tort and, therefore, may ...

s. Many times when a person has abused anabolic steroids and commits

violent crime A violent crime, violent felony, crime of violence or crime of a violent nature is a crime in which an offender or perpetrator uses or threatens to use harmful Force (law), force upon a victim. This entails both crimes in which the violence, vio ...

s, they do not maintain the same levels of judgement to their actions, which may lead to

aggravated Aggravation, in law, is "any circumstance attending the commission of a crime or tort which increases its guilt or enormity or adds to its injurious consequences, but which is above and beyond the essential constituents of the crime or tort itself" ...

murders. The abuse of other drugs can lead to a worsening effects of aggression and violence that a person may commit. 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 Verbal abuse (also known as verbal aggression, verbal attack, verbal violence, verbal assault, psychic aggression, or psychic violence) is a type of Psychological abuse, psychological/mental abuse that involves the use of Oral language, oral or w ...

and physical

domestic abuse Domestic violence is violence that occurs in a domestic setting, such as in a marriage or cohabitation. In a broader sense, abuse including nonphysical abuse in such settings is called domestic abuse. The term "domestic violence" is often use ...

Treatment

Certain drugs that minimise the amount of

oestrogen Estrogen (also spelled oestrogen in British English; see spelling differences) is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three m ...

created as the anabolic steroids break down could help lessen the aggression. Anabolic steroid users can go into a psychosis when roid rage is induced, and even start experiencing

suicidal ideation Suicidal ideation, or suicidal thoughts, is the thought process of having ideas or ruminations about the possibility of dying by suicide.World Health Organization, ''ICD-11 for Mortality and Morbidity Statistics'', ver. 09/2020MB26.A Suicidal i ...

, some

antipsychotic Antipsychotics, previously known as neuroleptics and major tranquilizers, are a class of Psychiatric medication, psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), p ...

medications, such as

haloperidol Haloperidol, sold under the brand name Haldol among others, is a typical antipsychotic medication. Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, delirium, agitation, acute psychos ...

, have been used extensively to treat the psychosis induced roid rage, evidence also exists to support second-generation antipsychotics,

lithium Lithium (from , , ) is a chemical element; it has chemical symbol, symbol Li and atomic number 3. It is a soft, silvery-white alkali metal. Under standard temperature and pressure, standard conditions, it is the least dense metal and the ...

, selective

serotonin Serotonin (), also known as 5-hydroxytryptamine (5-HT), is a monoamine neurotransmitter with a wide range of functions in both the central nervous system (CNS) and also peripheral tissues. It is involved in mood, cognition, reward, learning, ...

reuptake inhibitors,

tricyclic antidepressant Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade. They are named after their chemical structure, which contains ...

s (TCAs), and select

antiepileptic Anticonvulsants (also known as antiepileptic drugs, antiseizure drugs, or anti-seizure medications (ASM)) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also used in the treatmen ...

drugs, including

carbamazepine Carbamazepine, sold under the brand name Tegretol among others, is an anticonvulsant medication used in the treatment of epilepsy and neuropathic pain. It is used as an adjunctive treatment in schizophrenia along with other medications and as ...

as well as

valproic acid Valproate (valproic acid, VPA, sodium valproate, and valproate semisodium forms) are medications primarily used to treat epilepsy and bipolar disorder and prevent migraine headaches. They are useful for the prevention of seizures in those with ...

and its derivatives.

In popular culture

In a season 8 episode of ''

South Park ''South Park'' is an American animated sitcom created by Trey Parker and Matt Stone, and developed by Brian Graden for Comedy Central. The series revolves around four boysStan Marsh, Kyle Broflovski, Eric Cartman, and Kenny McCormickand the ...

'', " Up the Down Steroid", the character

Jimmy Jimmy may refer to: Arts and entertainment Film and television * ''Jimmy'' (2008 film), a 2008 Hindi thriller directed by Raj N. Sippy * ''Jimmy'' (1979 film), a 1979 Indian Malayalam film directed by Melattoor Ravi Varma * ''Jimmy'' (2013 f ...

goes into a roid rage after use of

. In a season 7 episode of ''Family Guy'', "

Stew-Roids "Stew-Roids" is the 13th episode in the seventh season of the American animated television series ''Family Guy''. It originally aired on the Fox network in the United States on April 26, 2009. The episode features Stewie after he is attacked ...

", the character

Stewie Griffin Stewart Gilligan "Stewie" Griffin is a fictional character from the animated television series ''Family Guy''. He is voiced by series creator Seth MacFarlane and first appeared on television, along with the rest of the Griffin family, in the ...

develops roid rage after his father

Peter Griffin Peter Löwenbräu Griffin Sr. ( né Justin Peter Griffin) is a fictional character and the protagonist of the American animated sitcom ''Family Guy''. He is voiced by the series' creator, Seth MacFarlane, and first appeared on television, a ...

gives him steroids in order to make him stronger at the gym.

References

{{Reflist Anabolic–androgenic steroids Drug safety