Anabolic steroids are synthetic derivatives of testosterone that are widely used both for sport and to achieve an athletic body image.

Its use has increased greatly in recent years.

The abuse is associated with side effects both physically (endocrine, cardiovascular, liver …) and psychological (anxiety disorders, depression, psychosis, aggression, suicide), in some cases severe and irreversible.

Many sports supplements are contaminated with these substances.

Based on the exposure of a clinical case, we conducted a systematic review in various databases.

25 year old male with no personal or family psychiatric history. It has no history of drug toxicity.

Coinciding with a period of major stress (working as a private escort and simultaneously preparing exams for police) he started intensive physical training and sports supplements diet (including anabolic steroids). The patient gradually begins to appear nervous, irritable and sleep disturbance. Acutely presents a picture of delusions of prejudice, self-referentiality and elevated distress so he needed an urgent psychiatric income. Was treated with risperidone 4mg/day and lorazepam 5mg/day. Psychotic symptoms disappeared within two days. During outpatient follow-up medication was gradually reduced. The evolution has been favorable getting a full recovery in few weeks.

The steroid-induced psychotic episodes are rare, mainly consisting of paranoid delusions or grandeur, usually in the context of a manic episode.

In most reported cases, the psychotic symptoms disappear quickly, within several weeks after discontinuation of the offending substance. Occasionally required a brief treatment with antipsychotics.