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Clinical Nurse Specialist: The Journal for Advanced Nursing Practice

October 2012, Volume 26 Number 5 , p 250 - 253




Recently, we had a 21-year-old patient admitted for severe anxiety, resting tremor, and chest pain. An assessment revealed that the young man had consumed multiple caffeinated energy drinks and shots with alcohol. Caffeine toxicity was the discharge diagnosis and intoxication. All other drug screens were negative.I was surprised how significant the symptoms were. Based on reports from the patient and his friends, the symptoms of tremor, nausea, and tachycardia occurred very soon after ingestion of multiple energy drinks in a short period. How common is caffeine toxicity? Why are there not more health warnings regarding use of these products? They certainly don't appear dangerous.Found in a wide variety of beverages and pharmaceuticals, caffeine is known for its thermogenic and appetite suppression properties. With an average half-life of 4.9 hours (can increase to 5-10 hours in women taking oral contraceptives), this adenosine and benzodiazepine receptor antagonist, phosphodiesterase inhibitor, and stimulant are the primary active ingredients in the explosion of energy drinks (EDs) in the market place.1,2 Typical EDs contain up to 300 mg of caffeine.3Table 1 describes some of the ingredients added to EDs. Guarana, taurine, L-carnitine, ginseng, yohimbine, or cocoa and other unregulated contributions of caffeine are generally not accounted for in labeling because the elements are claimed as "dietary supplements."1-3 Energy drinks may also contain vitamins, significant sugar, or artificial sweeteners. Marketed to improve energy, increase stamina, reduce fatigue, and enhance performance, EDs have become part of the cultural landscape.1-3Evidence suggests that 30% to 50% of US teens consume EDs, and 62% drink at least 1 sports drink a day.4 In fact, consumption of EDs by children and adolescents is increasing at alarming rate, which may be a function of ignorance and/or intense media and Web marketing.4,5 With promises of relief from fatigue and energy for the long haul,

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