Last Updated: 2009-05-28 18:30:20 -0400 (Reuters Health)

Chewing several sticks of stimulant chewing gum within a period of 4 hours landed a 13-year-old boy in the hospital with caffeine intoxication, Italian investigators report in the May 30 issue of The Lancet.

The boy was taken to the emergency department by his parents, who reported that he had been agitated and aggressive upon returning home from school that day, and he complained of abdominal discomfort, increased and painful urination, and prickling sensations in his legs.

At the emergency department of Monaldi Hospital in Naples, where Dr. Francesco Natale and his associates practice, the patient’s heart rate was 147 beats per minute, his respiration rate was 25 breaths per minutes, and his blood pressure was 145/90.

The 45-kg patient admitted to chewing two packets of "energy" gum at school, containing a total of 320 mg caffeine.

He was discharged the following day, but he remained sluggish and sleepy. At a clinic visit after missing 3 days of school, an electrocardiogram showed sinus bradycardia (45 beats per minute) and low left-ventricular ejection fraction (55%). It took 5 more days before his condition returned to normal.

"The use of stimulant chewing gum should be considered in cases of caffeine intoxication," Dr. Natale and associates advise. "The risk of intoxication is high in children and teenagers in view of general caffeine-naivety, and the unrestricted sale of these substances."

A search of the internet revealed a wide variety of stimulant chewing gums, with brand names such as Mad-Croc, Pepp, Jolt, KickBrix, Penguin, and Blitz. The companies state that one or two pieces of their gum is equivalent to one cup of coffee (90 to 100 mg). KickBrix advertises its product as "one-quarter the price of an energy drink." Stimulant chewing gums are sold at retail stores and over the internet.

Lancet 2009;373:1918.Legislation