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 0.08
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.
📅 Last reviewed: 2026-07-14 ⓘ
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
6 support 1 contradict 4 tested null 11 mixed · 22 sources, 7 independent groups
The evidence (22)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Bonenti B et al 2026 · study_type: observational | observational | mixed | low | In 1146 men with past-year AAS use, the trenbolone subgroup (n=237) reported significantly more mood instability, irritability and depressive symptoms than non-trenbolone AAS users (all p<0.001, phi=0.13-0.20). Cross-sectional self-report c |
| Santos 2024 · Saudi Pharm J | observational | supports | low | AAS increased aggression and neuroinflammation in female rodents and were linked to mood changes and psychiatric disorders in women. |
| Grant B et al 2023 · study_type: observational | observational | supports | low | Anonymous survey of 470 men using AAS: 35.3% self-reported increased aggression as an on-cycle effect (51.7% reported no issues at all). Purely descriptive self-report survey with no comparator group or validated aggression scale. |
| Berger K et al 2024 · study_type: observational | observational | mixed | low | Comparison of doped adolescent athletes vs non-doped athletes vs non-athletes (retrospective, GDR-era cohort): doping group showed more neuroticism, less extraversion, and more depression/PTSD symptoms. Authors explicitly attribute part of |
| Ceto E et al 2025 · study_type: observational | observational | supports | low | 319 male bodybuilders: AAS users scored significantly higher on the Buss-Perry Aggression Scale overall and every sub-dimension (physical aggression, anger, hostility, verbal aggression; all p<0.001) plus narcissism (p<0.001). Cross-section |
| Bonenti B et al 2025 · study_type: observational | observational | mixed | low | 1146 men with past-year AAS use, stratified by age: younger users (<40) were significantly more likely than older users to report anger and depression (chi-square p<0.045). Cross-sectional, AAS-only sample (no non-user comparator) with self |
| Çınaroğlu M et al 2025 · study_type: observational | observational | mixed | low | 285 gym-goers (87 long-term PED/AAS users, 95 short-term, 103 non-users): long-term users reported significantly higher anxiety (BAI) and depression (BDI-II) than short-term users and non-users, with a duration-dependent gradient. Cross-sec |
| Henriksen HCB et al 2023 · study_type: observational | observational | mixed | low | Cross-sectional self-report of 90 Norwegian men with >12 months AAS use: all 90 reported side effects, and treatment-seekers reported significantly more depression and anxiety than non-treatment-seekers. No non-AAS-user comparison group; en |
| Lieberman 2024 · Psychopharmacology | RCT | tested-null | low | 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. |
| Börjesson A et al 2024 · study_type: observational | observational | mixed | low | Qualitative phenomenological interviews with 12 next-of-kin of AAS users describe observed 'mood swings, aggressiveness...anxiety, and emotional coldness' in the user. Third-party qualitative report, no validated instruments, small sample, |
| Mhillaj 2015 · Front Neurosci | observational | mixed | low | Preclinical and clinical review links supratherapeutic AAS to anxiety, aggression and irritability via reward-system and neurotransmitter changes. |
| Windfeld-Mathiasen J et al 2022 · study_type: observational | observational | mixed | low | 545 men doping-sanctioned for AAS vs 5450 matched controls (national registry data): incidence of anxiolytic (HR 2.34) and antipsychotic (HR 2.69) prescriptions rose sharply after AAS sanction, and antidepressant use was already elevated pr |
| 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 | low | 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). |
| Dubol M et al 2026 · study_type: RCT | observational | tested-null | low | Healthy women given 1 week of low-dose testosterone (10 mg/day, ~33-fold increase in peripheral testosterone) showed no significant change in psychometric depression, anxiety, or aggression scores versus baseline/PET imaging controls. Rando |
| Freire-Arvelo JA et al 2025 · study_type: animal | animal | contradicts | moderate | Prepubertal male rats given daily nandrolone decanoate (20 mg/kg, days 28-37) showed REDUCED anxiety-like behavior and ambulation, not increased anxiety, alongside altered striatal/cortical D2 dopamine receptors. No self-selection confound |
| Jørstad ML et al 2023 · study_type: observational | observational | supports | low | 118 male AAS users vs 97 non-using weightlifters (MCMI-III): AAS users scored significantly higher on nearly all personality-disorder and clinical-syndrome scales (anxiety-related syndromes among them), with a distinct 'severe multipatholog |
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