Case reports and small studies indicate that anabolic steroids increase irritability and aggression,75 although findings may be confounded by personality traits that are overrepresented in steroid users (i.e., antisocial, borderline, and histrionic personality disorder)78 and use of other drugs.79 People who misuse anabolic steroids report more anger than nonusers,80 as well as more fights, verbal aggression, and violence toward their significant others,81 sometimes called "roid rage." One study suggests that the mood and behavioral effects seen during anabolic-androgenic steroid misuse may result from secondary hormonal changes.82

A $252 million contract to play baseball causes "an enormous amount of pressure ... to perform at a high level every day," according to Alex Rodriguez, who provided details about the steroids he used as a professional athlete.

Legal steroids refer to workout supplements that may increase muscle mass and athletic performance. However, they are not the same as anabolic steroids. Anabolic steroids are illegal without a prescription.

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Anabolic-androgenic steroids, often shortened to "anabolic steroids," "steroids," or "androgens,"2,3 are the most widely misused APED. These are synthetic substances similar to the male sex hormone testosterone. They promote the growth of skeletal muscle (anabolic effects) and the development of male sexual characteristics (androgenic effects) in both males and females.2

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