Nonprescription Stimulants in Children

Gardiner P, Breuner CC, Kemper KJ: What's the BUZZ? Nonprescription stimulants in the youthful population. Contemp Ped 2003; 20(8):63-81.

Herbal stimulants are easily purchased and widely available, and a drug history may not elicit information about the use of such "natural" substances. This informative article reviews two categories of herbal drugs: caffeinated stimulants, including black and green tea, coffee, soft drinks, guarana, and yerba mate, and noncaffeinated stimulants including panax ginseng and ma huang (ephedra).

Nursing mothers who consume 2 quarts of green tea daily because it is a powerful antioxidant may have infants who are irritable and have trouble sleeping. One cup of green tea contains 22 to 46 mg of caffeine, which passes through breast milk. Women who take a "natural sport supplement" containing ephedra may get more than an energy enhancement. Over 900 cases of possible ephedra toxicity were reported by 1995, including sudden deaths, psychosis, and tachyarrhythmias. Health care providers are encouraged to expand drug history questions to include herbal, natural, vitamin, and mineral supplements specifically.