APPENDIX

Representative Sample of Adverse Events Reported in Association With Nonalcoholic Energy Drink Consumption

Source of InformationNo. and of Age PatientsPrevious Health ConditionsSymptomsReported Association With Energy DrinkRef No.
Journal articles/case reportsOne 25-y-old womanMitral valve prolapseUnknownDrank a bottle of Race 2005 Energy Blast with guarana and ginseng on the day that she had a cardiac arrest; the autopsy and toxicological screen results were negative except for a caffeine concentration of 19 mg/L in aortic blood29
One 25-y-old manNone reportedGeneralized seizures on 2 occasions over 4 mo; the seizures did not reoccur within 6 mo after abstaining from energy drinksReportedly drank energy drinks on an empty stomach; he reported consuming two 24-oz energy drinks 30–60 min before the seizure27
One 31-y-old manNone reportedRhabdomyolysis and acute kidney failure with tubular necrosisActive football referee drank 3 cans of Red Bull before a 3000-m competition; the authors stated that the taurine could have caused the rhabdomyolysis from hyperosmolarity because the distance was relatively short compared with his normal training25 and 38
One 43-y-old manParanoid-type schizophrenia and alcohol dependence in full, sustained remission6-wk history of worsening paranoia, delusions, and agitation resulting in hospitalizationStarted drinking energy drinks 2 wk before becoming symptomatic; consumption increased to 8–10 cans per d; the cessation of caffeine reportedly improved symptoms114
One 47-y-old manNone reportedDelusions and paranoia; the psychosis resolved within 7 wk after reducing caffeine consumptionHigh caffeine intake13
2 patientsMigraine headachesSeizuresIn 1 case, the energy drink was consumed on an empty stomach; in the other case, caffeine tablets were also consumed with the energy drink26
2 depressed patients and 1 patient with no psychiatric illnessStarted on ginseng for several monthsUnknownMania, which resolved after stopping taking ginseng8
One young professional volleyball playerNone reportedDeveloped orthostatic intolerance, postural tachycardia, and syncope, which resolved after energy drink consumption was stopped4–5 cans of Red Bull per d75
Newspaper articles4 middle school studentsNone reportedAll transported to the hospital with tachycardia, hypertension, paresthesias, diaphoresis, jitters/anxiety; hypokalemia and hyperglycemia were diagnosed in the emergency departmentAll 4 shared 1 can of Redline energy drink16
7 high school studentsNone reportedShortness of breath, heart palpitations, nausea; 2 students were treated in a hospitalSPIKE Shooter34
One teenaged boyNone reportedSevere stomach pain for ∼2 mo; endoscopic findings included severe inflammation, bleeding, and ulcerations in the duodenumSeveral Redline energy drinks (250 mg of caffeine per 8-oz serving) per d32
Marin InstituteOne 14-y-old girlDiabetes2 d after drinking 1 can of SPIKE Shooter, she was hospitalized for a seizureSPIKE Shooter43
One 18-y-old girlNone reportedDied after sharing 4 cans of Red Bull with friends and then playing basketballRed Bull43
Online news sourcesOne 14-y-old girlDiabetesSeizureReportedly drank 1 can of an energy drink before the seizure25 and 38
One 17-y-old girlNone reportedCollapsed at the finish of a track race and was rushed to the emergency department after reporting chest pain and fatigueRegularly skipped breakfast and drank 2 or 3 cans of Red Bull1
One 28-y-old manNone reportedThe man reportedly drank energy drinks and then engaged in the strenuous physical activity of motocross; he subsequently died from a cardiac arrest, presumably from coronary vasospasm caused by the energy drinksUnknown energy drink; unspecified but large numbers of energy drinks that contained high levels of caffeine and taurine were consumed28
One 47-y-old manNone reported“I thought I was having a heart attack. I thought I was going to die.” The next day he reported feeling sore and exhausted from the experienceTwo 8-oz cans of VPX Redline119