Caffeine-Containing Energy Drinks/Shots: Safety, Efficacy, and Controversy

Abstract Caffeine-containing energy drinks/shots (CEDS) have become the fastest growing product category within the beverage industry. Coincident to the rapid rise in CEDS consumption, especially among adolescents and young adults, are concerns regarding their efficacy and safety. Much of the controversy surrounding CEDS can be traced to their principal ingredient, caffeine. Caffeine, the world's most consumed and studied drug, is well known for its central nervous system (CNS) and cardiovascular stimulant effects. While caffeine-containing beverages like coffee and tea have been a mainstay in the human diet for over 500 years, safety concerns for these beverages are minimal, owing in part to their preparation as decoctions with relatively low caffeine content. Safety concerns for CEDS appear to be linked to misuse, individual susceptibilities, and combining these products with alcohol, prescription stimulants, or vigorous exercise. Marketing strategies coupled with higher caffeine content per volume may also contribute to reports of adverse health effects linked to CEDS. However, when consumed in moderation and not combined with alcohol, safety concerns for CEDS appear minimal. This review will address some of the pharmacological and pharmaceutical issues that distinguish CEDS from traditional caffeine-containing beverages. Such distinctions are likely to “energize” the current controversy surrounding these products.