Acute Psychosis Due to the Interaction of Legal Compounds — Ephedra Alkaloids in ‘Vigueur Fit’ Tablets, Caffeine in ‘Red Bull’ and Alcohol

A short-lasting episode of acute psychosis in a 32-year-old male which followed the consumption of alcohol, caffeine and ‘vigueur fit’ tablets containing ephedra alkaloids is reported. Less than two days after the event, a urine sample contained 22 μg/ml of ephedrine and 5 μg/ml of pseudoephedrine....

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Bibliographic Details
Published in:Medicine, science, and the law science, and the law, 2001-10, Vol.41 (4), p.331-336
Main Authors: Tormey, W P, Bruzzi, A
Format: Article
Language:English
Subjects:
Adult
Alcohol Drinking - adverse effects
Caffeine - administration & dosage
Caffeine - adverse effects
Central Nervous System Stimulants - administration & dosage
Central Nervous System Stimulants - adverse effects
Drug Interactions
Ephedrine - administration & dosage
Ephedrine - adverse effects
Ethanol - adverse effects
Humans
Male
Obesity - drug therapy
Phytotherapy - adverse effects
Psychoses, Substance-Induced - etiology
Substance Abuse Detection
Violence - legislation & jurisprudence
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Summary:A short-lasting episode of acute psychosis in a 32-year-old male which followed the consumption of alcohol, caffeine and ‘vigueur fit’ tablets containing ephedra alkaloids is reported. Less than two days after the event, a urine sample contained 22 μg/ml of ephedrine and 5 μg/ml of pseudoephedrine. Despite detailed pharmacological evidence being given at a jury trial, he was convicted of assault and trespass and was fined £16,000. An earlier incident involving misbehaviour on an aircraft again involving alcohol and ephedrine resulted in a conviction and a court order to provide twice weekly urine tests for alcohol for a period of six months. He stopped taking the alkaloid tablets after the second incident. There was no history of aberrant behaviour in this man outwith the period when taking these tablets. Ephedra alkaloids may cause psychosis and their effects can be exaggerated by interaction with caffeine and ethanol. To protect the public, the use of stimulant drugs in over-the-counter weight control programmes should be prescription only and the package insert should include a warning on the dangers of concomitant use of ethanol.
ISSN:0025-8024
2042-1818
DOI:10.1177/002580240104100410