RAND reviewed adverse events reported in 52 published randomized controlled clinical trials. No serious adverse events (death, myocardial infarction, cerebrovascular/stroke events, seizure, or serious psychiatric events) were reported in the clinical trials. However, evidence from the trials was sufficient to support the conclusion that the use of ephedrine, ephedrine plus caffeine, or ephedra plus caffeine is associated with 2-3 times the risk of nausea, vomiting, psychiatric symptoms such as anxiety and change in mood, autonomic hyperactivity, and palpitations. The contribution of caffeine to these symptoms cannot be determined.
There seems to be a disagreement in the literature about the facts. This one had randomized controlled trials. Maybe the sample size was too small though? In that case, are the “suggestions” of a safety problem enough to be a concern? How strong were these suggestions? Obesity also increases risk of death. Perhaps ECA still wins on net cost-benefit. Maybe the risks are very small. Death is a very serious side effect, to be taken very seriously, unfortunately, many over-the-counter medications we use routinely carry this risk. Degrees of risks matter. Maybe the ephedrine was correlated but wasn’t the cause. We’d need the numbers, and maybe more statistical know-how than I’ve got.
The safety information I had came from here.
There seems to be a disagreement in the literature about the facts. This one had randomized controlled trials. Maybe the sample size was too small though? In that case, are the “suggestions” of a safety problem enough to be a concern? How strong were these suggestions? Obesity also increases risk of death. Perhaps ECA still wins on net cost-benefit. Maybe the risks are very small. Death is a very serious side effect, to be taken very seriously, unfortunately, many over-the-counter medications we use routinely carry this risk. Degrees of risks matter. Maybe the ephedrine was correlated but wasn’t the cause. We’d need the numbers, and maybe more statistical know-how than I’ve got.