Mood Changes on Steroids: Roid Rage and Real Risks

Roid rage in three numbers

Three study figures put roid rage in proportion.

Study figures come from PubMed papers. Doses users take in practice are often higher and mixed; where we describe practice, we say so.

What this roid rage guide covers

What is roid rage?

Roid rage is a popular name for anger, irritability or violence blamed on anabolic steroids. It is not a medical diagnosis.

Researchers usually measure it as aggression scores, manic symptoms or violent acts. Those are different things, and the data differ for each.

Steroid users often take very high doses, combine several drugs and use other substances. That makes the cause hard to pin down, the Endocrine Society notes (PMID 24423981).

Is roid rage real?

Yes, for some people, and usually mild. A meta analysis of 12 randomized trials in 562 healthy men found steroids raised self reported aggression a little. The effect size was 0.171 (PMID 33745011).

That rise was not seen in observer reported aggression. It also did not show in the analysis of higher doses over 500 mg or longer use (PMID 33745011).

In a 1996 trial, 600 mg of testosterone a week for 10 weeks did not alter mood or behavior in any group (PMID 8637535).

The key roid rage trial: 600 mg a week

In 2000, 56 men took testosterone cypionate rising to 600 mg a week for 6 weeks, and placebo for 6 weeks (PMID 10665615).

Testosterone raised manic scores and aggressive responses on a provocation test (PMID 10665615).

But reactions varied a lot. Of 50 men, 42 had minimal effects, 6 became mildly hypomanic and 2 markedly hypomanic (PMID 10665615).

The 8 men who reacted did not differ at baseline from the 42 who did not. Nothing predicted who would react (PMID 10665615).

Steroids and violence: what the crime data show

A small link. A meta analysis of 14 studies and 137,055 people found a significant but small link between steroid use and violence, r = 0.21 (PMID 37467456).

Most studies could not show which came first, the steroids or the violence (PMID 37467456).

Other drugs explain much of it. In 10,365 Swedish men, steroid use raised the odds of a violent conviction 5.0 times. After accounting for other drug use, it fell to 1.6 times, not significant (PMID 25170826).

But the gap stays in some data. In Denmark, 20.6% of 545 men caught with steroids in gyms already had a prison sentence, vs 3.7% of controls (PMID 31421475).

Over follow up it rose to 29.5% vs 4.9%. The risk stayed high after adjusting for drug abuse and psychiatric illness (PMID 31421475).

In US young adults, steroid users reported more violence even after adjusting for past violence and other drugs (PMID 18923108).

Who is most at risk of roid rage?

Dependent users. In 139 weightlifters, men who met dependence criteria reported the most aggression. Antisocial personality traits were an important link (PMID 33621808).

Polydrug users. Other substance use explained most of the violence link in Sweden (PMID 25170826).

High doses and stacks. Users often take far above medical doses and combine drugs, which raises every risk (PMID 24423981).

An unpredictable few. In the trial, nothing at baseline flagged the men who became hypomanic (PMID 10665615).

Roid rage symptoms and mood changes on steroids

People close to you often notice changes before you do. In the trial, partners also kept weekly diaries (PMID 10665615).

Depression after a steroid cycle

The bigger mood problem is often after the cycle, not during it.

In 24 former long term users, 7 (29%) had major depression during withdrawal. Four had never had depression before (PMID 25598171).

About 2.5 years after stopping, 24.2% of former users had depressive symptoms, more than controls. 40.1% reported low libido (PMID 27532478).

This tracks with low testosterone after cycles. Former users had lower testosterone than controls years later (PMID 27532478).

Does TRT cause mood swings?

TRT targets normal testosterone levels, far below cycle doses. See is TRT a steroid.

In 790 men aged 65 or older, testosterone gel raised levels to mid normal for a year. Men reported slightly better mood and fewer depressive symptoms than on placebo (PMID 26886521).

What helps with mood changes on steroids

Verdict: 5 facts about roid rage

1. It is real but uncommon. 8 of 50 men reacted at 600 mg a week (PMID 10665615).

2. The average effect is small. Aggression effect size 0.171 in 12 trials (PMID 33745011).

3. Violence is mostly about other drugs. Odds fell from 5.0 to 1.6 (PMID 25170826).

4. Dependence raises the risk. Most aggression in dependent users (PMID 33621808).

5. Depression after cycles is common. 29% during withdrawal (PMID 25598171).