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Drug interactions (6/11/2004)
A few weeks ago I had one of those "energy drinks" at about noon and I felt a bit strange shortly afterwards. I have drunk this stuff many times without any problems so I thought no more about it. Last Friday I was rushing back to the office after seeing a client and I grabbed a can of Red Bull to have with my ham sandwich for lunch. About half an hour later I had a strange form of anxiety attack. As the time of day seemed to have something to do with the reaction to this kind of drink, I thought about what else I do at about the same time each day and the obvious answer was the medication that I take at breakfast time. I went to Google to look for sites mentioning guarana and the medication. The vast majority of sites offered to sell me both the medication (which is available on prescription only) and various mixtures of herbs and spices, but none of them mentioned any possible interactions. They never do. A couple of sites warned that excessive consumption of energy drinks could induce panic attacks, but I feel it safe to assume that one can is not "excessive". The site for the book Herbal Remedies for Dummies had the most relevant information, where it listed a whole lot of dangerous possible interactions between herbs and drugs just after saying that drug-herb reactions are rare(!).
Most people seem to think that it is the caffeine in energy drinks which has the most effect, but a can of Red Bull only has as much caffeine as one cup of filter coffee or two cans of Coca Cola. I drink coffee all day without any weird effects, so there must be something else in the mixture which causes my strange drug interaction. It could be related to the rate of metabolism of the drinks (Red Bull say that the effect kicks in at about 30 minutes) and it almost certainly has to do with the time since the pill was taken. I am not suggesting that there is anything wrong with drinking Red Bull or any other energy drink, but my experience shows that it is not always possible to know in advance how the various things you put into your body will get along with each other. This one of the reasons why I object to amateurs prescribing mixtures of herbs of unknown composition to treat complaints for which there is no evidence of the herbs' effectiveness. You can see something else I have written about this here.