Which patient groups are at highest risk for caffeine toxicity?

Updated: Oct 24, 2020
  • Author: David Yew, MD; Chief Editor: Michael A Miller, MD  more...
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Caffeine is the most commonly used drug in the world, and its use is prevalent in essentially all races and ethnic groups. [1]  No scientific data have demonstrated that the outcomes of caffeine exposure differ on the basis of race or sex. [19]

Whether or not the effects of caffeine on adults can be generalized to children is unclear; however, studies suggest that children are differently affected by caffeine. One study comparing the effects of caffeine in men and boys found that the same dose of caffeine raised blood pressure in both groups but only decreased heart rate in boys. They also found that boys exhibited increased motor activity and speech rates and decreased reaction time compared with men. [20]

Another study found that an intake of 5 mg/kg body weight leads to elevated blood pressure and lower heart rate, without concomitant changes in energy metabolism in children aged 9-11 years. This amounts to 160 mg caffeine/day in a 10-year-old child weighing 30 kg, which is equivalent to the caffeine content of a single 16-oz Monster or Rockstar energy drink. [21]

In 2016, the AAPCC reported that the most exposures to caffeinated energy drinks were in children younger than 6 years. The second highest number of exposures were in adults aged 20 years and older. [17]

Additional age-related concerns arise from the fact that many energy drinks are marketed toward youth and youth-related activities, such as extreme sports. Students and athletes often drink them to enhance performance. A survey of 496 college students found that 51% of those surveyed drank more than 1 energy drink per month, with the majority of students drinking several  energy drinks per week. The main impetus was the desire for increased energy and concentration, with the most common complaint being insufficient sleep or a disruption in their regular sleep cycles. [22]

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