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Drink to your health? Beware energy drinks’ risks

Vol. 5, No. 10 / October 2006

Energy drinks’ popularity has soared among consumers who crave an energy boost from the highly caffeinated herbal concoctions. Clinicians should ask patients about energy drink consumption because:

  • caffeine abuse can exacerbate mood and anxiety disorders and disrupt sleep patterns
  • herbal additives can cause physical and/or psychiatric side effects
  • some ingredients interact with prescription or OTC medications
  • effects of energy drinks may contribute to a patient’s presenting complaint.

Approximately 70% of patients1 do not report energy drink use because they believe these products are natural and safe. Ask patients if they consume energy drinks so you can alert them to the health risks.

A Stimulating recipe

Two main ingredients in most energy drinks are caffeine and carbohydrates in the form of glucose, sucrose, fructose, galactose, and maltodextrins (Table).


Caffeine and carbohydrate content of popular energy drinks

Drink name

Caffeine content

Carbohydrate content

Red Bull (8.5 oz)

80 mg

28 g

Full Throttle (16 oz)

144 mg

57 g

SoBe No Fear (16 oz)

158 mg

66 g

Source: American Beverage Association, SoBe Beverages, Red Bull

Carbohydrates. Four popular brands of energy drinks contain 28 to 66 grams of carbohydrates—a slice of whole wheat bread has 20 grams of carbohydrates. Urge patients taking antipsychotics that could cause weight gain to avoid these drinks.

Caffeine. Energy drinks contain 75 to 158 mg of caffeine per can—8 ounces of coffee has 150 mg of caffeine. Also, some products include the South American plant extracts guarana or yerba mate, which contain an unknown amount of caffeine.

High caffeine intake—≥300 mg/d—might exacerbate bipolar disorder’s manic symptoms. Also find out about additional caffeine intake from coffee, tea, soda, and some OTC medications, such as Excedrin.

Herbal ingredients. Ginseng or ginkgo biloba can cause patients to feel jittery or anxious. When taken in large amounts—the FDA has no guidelines on safe dosages—these ingredients can aggravate manic or psychotic symptoms.

Significant energy drink consumption—3 or more 8-oz drinks per day—can bring about physical side effects such as tachycardia and insomnia. Advise patients to limit their intake to 2 drinks per day, and suggest safer ways to increase energy levels such as moderate exercise and adequate sleep.


1. Ciocon JO, Ciocon DG, Galindo DJ. Dietary supplements in primary care: botanicals can affect surgical outcomes and follow-up. Geriatrics 2004;59(9):20-4.

Dr. Berigan is a contracting psychiatrist at Behavioral Health Services, Fort Huachuca, AZ.

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