UMEM Educational Pearls

Category: Toxicology

Title: Caffeine: The socially acceptable psychoactive drug

Keywords: Caffeine, Energy drinks (PubMed Search)

Posted: 1/7/2016 by Kathy Prybys, MD (Emailed: 1/8/2016) (Updated: 1/8/2016)
Click here to contact Kathy Prybys, MD

Caffeine is the most commonly used psychoactive substance in the world. It is widely available in coffee, tea, chocolate,soft drinks, OTC medicines, and energy drinks. The vast majority of people consuming caffeine appear to suffer no harm while enjoying it's stimulating effects. This has led to the widely held perspective that caffeine is a completely benign substance with no adverse health effects exists.

Although, children and adolescents are at particular risk, many caffeine containing products are specifically marketed at them. Alarmingly, statistics demonstrate that caffeine intake among children and adolescents has increased by 70% in the last 30 years. Energy drinks are of special concern as they represent the fastest growing component of the beverage industry, contain significant quantities of caffeine as well as high levels of sugar, and can place children at high risk for caffeine intoxication.

There are many negative health consequences documented with caffeine use which occur in a dose dependent manner with individuals differing in their susceptibility to caffeine-related adverse effects:

Acute Toxicity:
  • Arrhythmias
  • Anxiety
  • Agitation
  • Seizure
  • Nausea,vomiting, diarrhea
  • Diuresis
  • Metabolic disturbances
  • Hypotension
  • Rare fatalities

Chronic Effects:

  • Insomia
  • Palpitations
  • Headaches
  • Diuresis
  • Gastric acid secretion
  • Urinary incontinence in women
  • Adverse effect on wound healing process, the aging process of the human skin
  • Low birth weight babies
  • Withdrawal state
  • Increased risk of cardiovascular events (heart attack,strokes, peripheral artery disease and kidney failure) in young adults with mild hypertension.


Temple JL, Caffeine use in children: what we know, what we have left to learn, and why we should worry. Neurosci Biobehav Rev. 2009 Jun;33(6):793-806.
Reissig CJ. Caffeinated energy drinks-A growing problem. Drug and Alcohol Dependence. Vol 99. Issue 1-3, Jan 2009,1-10.
Cohen S. Gastric acid secretiom and lower esphageal pressure in response to coffee and caffeine. New Eng J Med. 293 (18): 897-9.
Jabbar SB, Fatal Caffeine overdose: a case report and review of the literature. Am J Forensic Med Pathol. 2013 Dec;34(4):321-4.