Caffeine and alcohol. Beyond commonplaces suggested by the presence of caffeine in energy drinks.

The mixed consumption of caffeinated and alcoholic beverages, both characterized by high concentrations of their psychopharmacologically active constituents, has recently seen, in particular in adolescents and young adults, an impressive boost characterized by a binge-like drinking behavior aimed at obtaining higher levels of alcohol intoxication. This rise of dysregulated consumption, grounded on the fallacious belief that caffeine might reduce the sedative and locomotor impairing effects of high alcohol intake, overall increases the intrinsic potential of alcohol to induce addiction and promote other negative consequences on health directly related to such excessive intake. Moreover, both caffeine and alcohol are endowed with known biphasic effects, and the consequences of their interactions may strictly depend on several factors including doses and modalities of consumption. Although several preclinical studies confirmed the ability of caffeinated and alcoholic drinks to influence each other’s effects, their results remain highly inconclusive. In fact, these studies have been mainly focused on characterizing the effects of the interaction between alcohol and the main ingredient of energy drinks, caffeine, and did not take into consideration that energy drinks are extremely variable in their caffeine’s content and also include other psychopharmacologically active ingredients. The present chapter takes the challenge to synthetically present a critical perspective on the lights and shadows of preclinical evidence on this critical topic that is related to potentially serious implications on public health.