Dependence and Withdrawal

Dopamine Signalling

How strongly dopamine is signalling, mostly in the reward and motivation circuits. This is the route by which a compound that raises prolactin ends up flattening drive: dopamine holds prolactin down, so a sustained prolactin rise is read backwards as reduced dopaminergic tone.

Dorsal Striatum

Where a repeated action stops being a choice and becomes a habit. Relevant because the transition from using a compound deliberately to using it by default is a real neural change.

Euphoria

A lifted, expansive, everything-is-working feeling, arriving within days on some compounds. Recorded because it is real, because it is a large part of why people continue, and because it is the strongest single predictor of the dependence pattern further down. Not marked as good or bad: it is the reward that makes the rest of the list acceptable to the person having it.

Nucleus Accumbens

Where reward is registered and where the decision to repeat something is made. Anabolic steroids are reinforcing in animals at this site, which is the anatomical reason dependence is possible at all.

Psychosis

Losing the ability to tell internal experience from external reality: delusions, hallucinations, or both. Rare, disproportionately reported on the strongly androgenic 19-nor compounds, and a medical emergency.

Withdrawal Syndrome

The cluster that arrives after stopping, while the natural axis is still shut down: flat mood, no drive, no libido, disturbed sleep, and in some cases suicidal thoughts. Separated from dependence because dependence is about the pull to continue and this is about what happens when you do not. It is the window in which almost all of the serious psychiatric events in the literature occur.