31 Mania, hypomania, and major depression have been significantly associated with exposure to steroids.32 PSEs due to anabolic androgen steroids are mostly seen in abusive users. These PSEs relate to drug concentrations in a definite pattern. Hypomania Is correlated with anabolic androgen Intake and major depression follows Its withdrawal.31 In chronic users Inhibitors,research,lifescience,medical of slow-liberation forms, lassitude or depression may be seen just before administration of the next dose. The abuse of anabolic androgen steroids seems prevalent among teenagers wishing to increase

muscular mass. It was found in subjects as young as 9 years old,209 with a possible peak at ages 15 and 16.210 In another study, with a sample of 12 000 American high-school students, a prevalence of 4% was found in young males.211 Steroid users often seek medical care for the acne

these medications Inhibitors,research,lifescience,medical induce or exacerbate. If family members complain of aggressiveness and mood inhibitor CHIR99021 changes (which are less noticed by the users themselves), the clinician might suspect of anabolic androgen abuse, especially in teenagers of male sex. β-Adrenergic antagonists (β-blockers) Depression, nightmares, and sexual Inhibitors,research,lifescience,medical dysfunction are commonly reported PSEs of β-blockers. Hallucinations have been attributed to propranolol.63,68 With oral administration, depression and agitation related to propranolol might be dose-dependent.69 Ophthalmic preparations of β-blockers may also induce these PSEs, eg, timolol.70 Withdrawal reactions Inhibitors,research,lifescience,medical to β-blockers can occur even with ophthalmic presentations; cases of rebound tachycardia were reported after ophthalmic timolol interruption. It has long been recognized that β-blockers cause psychiatric and sexual side effects. However, this has become controversial, selleck chemical according to recent studies. In a placebo-controlled trial, the authors found no difference

between propranolol and placebo groups for the occurrence of depressive symptoms or sexual dysfunction.212 A later review stated that ”β-blockers have no significant increased risk of depressive symptoms and only small increased Inhibitors,research,lifescience,medical risks of fatigue and sexual dysfunction.“213 Nevertheless, it could be that the risk of suicide increases in users of β-blockers.71 The conflicting results on β-blocker depression suggest Brefeldin_A that some may improve depression (eg, pindolol), others may worsen it, and others may have little effect.214 Conclusion This review shows that drug-induced PSEs may occur with several medications prescribed in internal medicine and that these side effects might be overlooked. A PSE can be a stressful and traumatic life event for patients and their families. For example, a person without known psychiatric antecedents who develops a drug-induced psychosis might suffer sequelae from the fear of having lost their mind or from hospitalization in a psychiatric ward.