Keywords
anabolic-androgenic steroids
mental health
aggression
anxiety
emotional regulation
sport psychology
systematic review
How to Cite
Abstract
Background. Trenbolone is one of the most potent anabolic-androgenic steroids (AAS) and is widely used outside approved medical indications to increase muscle mass and enhance athletic performance. Despite growing interest in its physiological effects, the psychological consequences of trenbolone use remain insufficiently systematized. Existing studies suggest a possible association between trenbolone use and alterations in emotional regulation, aggression, anxiety, sleep disturbances, mood fluctuations, and other psychological manifestations. However, the available evidence is inconsistent and appears to depend on study design, dosage, concomitant use of other anabolic-androgenic steroids, and individual characteristics of users.
Objective. To systematically synthesize contemporary scientific evidence on the psychological effects of trenbolone use, analyze the proposed neurobiological mechanisms underlying these effects, evaluate the quality of the available evidence, and identify priorities for future research.
Methods. A systematic review of the scientific literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Publications addressing trenbolone use and its psychological consequences were identified through searches of the PubMed, Scopus, Web of Science, and PsycINFO databases. The review included original research articles, systematic reviews, and meta-analyses investigating the psychological and behavioral effects of trenbolone use in adult populations.
Results. The available literature indicates that the most frequently reported psychological effects associated with trenbolone use include increased irritability, emotional lability, aggression, sleep disturbances, anxiety, hypomanic symptoms, and depressive manifestations following discontinuation. At the same time, substantial interindividual variability has been observed, and current evidence does not support the existence of a universal psychological profile of trenbolone users. Significant methodological limitations were identified across the reviewed studies, including the predominance of observational designs, reliance on self-reported data, concurrent use of multiple anabolic-androgenic steroids, and inadequate control of potential confounding factors.
Conclusions. Current scientific evidence suggests a potential association between trenbolone use and a range of adverse psychological manifestations in some users; however, the available data remain insufficient to establish causal relationships. Future prospective longitudinal studies are needed to distinguish the effects of individual anabolic-androgenic steroids while accounting for dosage, duration of use, concomitant pharmacological agents, personality characteristics, and baseline mental health status. A comprehensive synthesis of the existing evidence may contribute to improved prevention strategies, psychological support for athletes, and the development of evidence-based recommendations aimed at minimizing the potential psychological risks associated with anabolic-androgenic steroid use.
Keywords: trenbolone; anabolic-androgenic steroids; mental health; aggression; anxiety; emotional regulation; sport psychology; systematic review.
References
Bahrke, M. S., & Yesalis, C. E. (2004). Abuse of anabolic androgenic steroids and related substances in sport and exercise. Current Opinion in Pharmacology, 4(6), 614–620.
Bhasin, S., Brito, J. P., Cunningham, G. R., Hayes, F. J., Hodis, H. N., Matsumoto, A. M., Snyder, P. J., Swerdloff, R. S., & Wu, F. C. W. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 103(5), 1715–1744.
Bjørnebekk, A. (2019). Anabolic-androgenic steroid use and its impact on the brain. Current Opinion in Endocrine and Metabolic Research, 9, 84–90.
Bjørnebekk, A., Walhovd, K. B., Jørstad, M. L., Due-Tønnessen, P., Hullstein, I. R., & Fjell, A. M. (2017). Structural brain imaging of long-term anabolic-androgenic steroid users. Biological Psychiatry, 82(4), 294–302.
Brower, K. J. (2002). Anabolic steroid abuse and dependence. Current Psychiatry Reports, 4(5), 377–387.
Frati, P., Busardò, F. P., Cipolloni, L., Dominicis, E., & Fineschi, V. (2015). Anabolic androgenic steroid (AAS) related deaths: Autoptic, toxicological and histopathological findings. Current Neuropharmacology, 13(1), 146–159.
Hall, R. C. W., & Hall, R. C. W. (2005). Abuse of supraphysiologic doses of anabolic steroids. Southern Medical Journal, 98(5), 550–555.
Handelsman, D. J. (2021). Androgen misuse and abuse. Endocrine Reviews, 42(4), 457–501.
Hauger, L. E., Westlye, L. T., & Bjørnebekk, A. (2019). Anabolic androgenic steroid dependence is associated with executive dysfunction. Drug and Alcohol Dependence, 204, 107552.
Hildebrandt, T., Langenbucher, J., Lai, J. K., Loeb, K. L., & Hollander, E. (2011). Development and validation of the Appearance and Performance Enhancing Drug Use Schedule. Addictive Behaviors, 36(10), 949–958.
Ip, E. J., Barnett, M. J., Tenerowicz, M. J., & Perry, P. J. (2011). The Anabolic 500 survey. Substance Use & Misuse, 46(1), 121–131.
Kanayama, G., Brower, K. J., Wood, R. I., Hudson, J. I., & Pope, H. G. Jr. (2009). Treatment of anabolic-androgenic steroid dependence. Drug and Alcohol Dependence, 102(1–3), 1–13.
Kanayama, G., Hudson, J. I., & Pope, H. G. Jr. (2008). Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse. Drug and Alcohol Dependence, 98(1–2), 1–12.
Kanayama, G., Hudson, J. I., & Pope, H. G. Jr. (2018). Illicit anabolic-androgenic steroid use. Hormones and Behavior, 104, 12–21.
Karaca, S., et al. (2024). Anabolic-androgenic steroids are linked to depression and anxiety in male bodybuilders. Annals of Medicine, 56(1).
Kicman, A. T. (2008). Pharmacology of anabolic steroids. British Journal of Pharmacology, 154(3), 502–521.
McVeigh, J., Begley, E., & Bates, G. (2021). A review of anabolic androgenic steroid use. Drugs: Education, Prevention and Policy, 28(4), 307–318.
Nieschlag, E., & Vorona, E. (2015). Medical consequences of doping with anabolic androgenic steroids. European Journal of Endocrinology, 173(2), R47–R58.
Oberlander, J. G., & Henderson, L. P. (2012). The Sturm und Drang of anabolic steroid use. Frontiers in Neuroendocrinology, 33(3), 292–310.
Piacentino, D., Kotzalidis, G. D., Del Casale, A., Aromatario, M. R., Pomara, C., Girardi, P., & Sani, G. (2015). Anabolic-androgenic steroid use and psychopathology in athletes: A systematic review. Current Neuropharmacology, 13(1), 101–121. https://doi.org/10.2174/1570159X13666141210222725
Pope, H. G. Jr., Kouri, E. M., & Hudson, J. I. (2000). Effects of supraphysiologic doses of testosterone on mood and aggression in normal men. Archives of General Psychiatry, 57(2), 133–140.
Pope, H. G. Jr., Wood, R. I., Rogol, A., Nyberg, F., Bowers, L., & Bhasin, S. (2014). Adverse health consequences of performance-enhancing drugs. Endocrine Reviews, 35(3), 341–375.
Rasmussen, J. J., Selmer, C., Østergren, P. B., Pedersen, K. B., Schou, M., Gustafsson, F., & Faber, J. (2018). Former anabolic androgenic steroid users exhibit decreased testosterone levels and impaired fertility. European Journal of Endocrinology, 179(3), 149–157.
Sagoe, D., McVeigh, J., Bjørnebekk, A., Essilfie, M. S., Andreassen, C. S., & Pallesen, S. (2021). Polypharmacy among anabolic-androgenic steroid users: A descriptive metasynthesis. Substance Abuse Treatment, Prevention, and Policy, 16, 46.
Talih, F., Fattal, O., & Malone, D. (2007). Anabolic steroid abuse: Psychiatric and physical costs. Cleveland Clinic Journal of Medicine, 74(5), 341–352.
Thiblin, I., & Petersson, A. (2005). Pharmacoepidemiology of anabolic androgenic steroids. Fundamental & Clinical Pharmacology, 19(1), 27–44.
Torrisi, M., Pennisi, G., Russo, I., et al. (2020). Sudden cardiac death and anabolic androgenic steroids. Journal of Clinical Medicine, 9(4), 1075.
Wood, R. I. (2008). Anabolic-androgenic steroid dependence? Insights from animals and humans. Frontiers in Neuroendocrinology, 29(4), 490–506.
Yesalis, C. E., & Bahrke, M. S. (2000). Doping among adolescent athletes. Baillière's Best Practice & Research Clinical Endocrinology & Metabolism, 14(1), 25–35.
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