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Hooked on Hormones-Reply

Kenneth B. Kashkin, MD; Herbert D. Kleber, MD
JAMA. 1990;263(15):2049. doi:10.1001/jama.1990.03440150052019.
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In Reply. —  We thank Drs Rosse and Deutsch for presenting their evidence for the interaction of sex steroids with benzodiazepine/γ-aminobutyric acidA receptors. There is other evidence for such interactions.1 Based on such data and the clinical similarity of acute alcohol and steroid withdrawal syndromes, agents used in the treatment of alcohol withdrawal (benzodiazepines, α2-adrenergic agonists, and β-adrenergic antagonists) should be investigated for effectiveness in reducing hyperadrenergic symptoms precipitated by anabolic steroid withdrawal. Alcohol withdrawal-type seizures have not been reported in anabolic steroid users, although this may be related to the long half-life of elimination of the steroids ingested or injected. Interestingly, anabolic steroids may be more like alcohol than like the rapidly addicting stimulants, such as cocaine, in their potential to produce a substance dependence disorder.Drs Rosse and Deutsch's data highlight the complex biochemical, if not clinical, relationships of steroid, alcohol, sedative/hypnotic, opioid, and stimulant


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