Biological Psychiatry Laboratory, McLean Hospital, Belmont, and Harvard Medical School, Boston, MA 02478, USA.
Horm Behav. 2010 Jun;58(1):111-21. doi: 10.1016/j.yhbeh.2009.09.006. Epub 2009 Sep 18.
The anabolic-androgenic steroids (AAS) are a family of hormones that includes testosterone and its derivatives. These substances have been used by elite athletes since the 1950s, but they did not become widespread drugs of abuse in the general population until the 1980s. Thus, knowledge of the medical and behavioral effects of illicit AAS use is still evolving. Surveys suggest that many millions of boys and men, primarily in Western countries, have abused AAS to enhance athletic performance or personal appearance. AAS use among girls and women is much less common. Taken in supraphysiologic doses, AAS show various long-term adverse medical effects, especially cardiovascular toxicity. Behavioral effects of AAS include hypomanic or manic symptoms, sometimes accompanied by aggression or violence, which usually occur while taking AAS, and depressive symptoms occurring during AAS withdrawal. However, these symptoms are idiosyncratic and afflict only a minority of illicit users; the mechanism of these idiosyncratic responses remains unclear. AAS users may also ingest a range of other illicit drugs, including both "body image" drugs to enhance physical appearance or performance, and classical drugs of abuse. In particular, AAS users appear particularly prone to opioid use. There may well be a biological basis for this association, since both human and animal data suggest that AAS and opioids may share similar brain mechanisms. Finally, AAS may cause a dependence syndrome in a substantial minority of users. AAS dependence may pose a growing public health problem in future years but remains little studied.
合成代谢-雄激素类固醇（AAS）是一类包括睾酮及其衍生物的激素。自 20 世纪 50 年代以来，这些物质一直被精英运动员使用，但直到 20 世纪 80 年代，它们才在普通人群中广泛滥用。因此，非法使用 AAS 的医学和行为影响的知识仍在不断发展。调查表明，数以百万计的男孩和男性，主要在西方国家，滥用 AAS 来提高运动表现或个人形象。女孩和女性使用 AAS 的情况要少得多。在超生理剂量下，AAS 会表现出各种长期的不良医学影响，特别是心血管毒性。AAS 的行为影响包括轻躁狂或躁狂症状，有时伴有攻击性或暴力行为，这些症状通常发生在服用 AAS 期间，以及在 AAS 戒断期间出现的抑郁症状。然而，这些症状是特异性的，只影响少数非法使用者；这些特异性反应的机制仍不清楚。AAS 使用者也可能摄入一系列其他非法药物，包括既可以增强身体外观或表现的“身体形象”药物，也包括经典的滥用药物。特别是，AAS 使用者似乎特别容易使用阿片类药物。这种关联可能有生物学基础，因为人类和动物数据都表明，AAS 和阿片类药物可能有相似的大脑机制。最后，AAS 可能会在相当一部分使用者中引起依赖综合征。AAS 依赖可能会在未来几年成为一个日益严重的公共卫生问题，但目前研究甚少。
