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The Down Side To Energy Drinks

Since their introduction in 1987, the energy drink market has grown exponentially. The main ingredient of energy drinks is caffeine. For comparison, the caffeine content in a 6 oz. cup of coffee varies from 77 to 150 milligrams, while in energy drinks caffeine can range from 50 to 500 mgs per can or bottle.  Energy drinks, depending on the brand, may also contain substances such as taurine, riboflavin, pyridoxine, nicotinamide, B vitamins, and various herbal derivatives. The effects of excessive and long-term use of these additives alone and in combination with caffeine are not fully known. This review by scientists at Johns Hopkins University suggests that these drinks may serve as gateways to other forms of drug dependence, have the potential for adverse health consequences, and may be cause for regulation.
Energy drinks are promoted for their stimulant effects. Advertising claims include increased attention, endurance, performance, and weight loss. Most of these claims have as yet to be proven. Some performance enhancement has been shown from caffeine but this may be counteracted by caffeine withdrawal. The review cites three hazards associated with the use of these drinks: caffeine intoxication, caffeine dependence, and caffeine withdrawal. Features of caffeine intoxication include nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, tachycardia, agitation, and in rare cases death. While there is debate surrounding the issue of caffeine dependence, there is compelling evidence that caffeine can produce a substance dependence syndrome in some users. Symptoms of caffeine withdrawal have been in the medical literature for over a century.

Mixing energy drinks with alcohol may increase the potential for adverse consequences. One well-known U.S. beer company has stopped the sale of caffeinated alcoholic beverages. Studies have also shown that lifetime caffeine use, toxicity, and dependence are significantly associated with various psychiatric disorders.

The lack of any regulatory oversight has allowed aggressive marketing of energy drinks aimed primarily at young males. The reviewers suggest it would be prudent to require product labels to fully disclose the amount of caffeine and other contents, and state the risks of combining these drinks with alcohol. They further recommend that in view of the increasing use of these drinks, clinicians become familiar with the features of caffeine intoxication, withdrawal, and dependence.

(Reissig, C, Strain, E, Griffiths, R: Caffeinated energy drinks – a growing problem. Drug and Alcohol Dependence 99:1-10, 2009)

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