A review by a committee composed of international scientists and chaired by a Yale researcher has found no evidence that caffeine in over-the-counter pain relievers leads to dependence.

A possible link between caffeine in analgesics, such as aspirin and acetaminophen, and resulting dependency had aroused considerable attention in Europe. In fact, various groups in Germany, Austria and Switzerland sought protective regulatory action. The committee to review the problem was chosen by federal drug authorities in the three countries as well as by the pharmaceutical industry.

The group of international scientists was chaired by Dr. Alvan R. Feinstein, Sterling Professor of Medicine and Epidemiology at Yale School of Medicine. They reviewed articles in peer-reviewed journals, editorials and any other appropriate publications. Because the literature provides only rare data on the role of caffeine in analgesic use, the panel also interpreted analgesic activity in studies on the abuse potential of caffeine in coffee or other beverages.

They noted that caffeine has a synergistic action with analgesics, enhancing their effectiveness. But they found that withdrawal from the use of analgesics containing caffeine is not likely to stimulate or sustain continued use of analgesics.

"Although caffeine has a dependence potential, the potential is low," the researchers concluded in the study published in the journal Clinical Pharmacology and Therapeutics. "Suspicions that caffeine combinations with analgesics might lead to dependence behavior are not supported by data, except in formerly used combinations with phenacetin."

Phenacetin is a pain killer, like other analgesics, that was withdrawn from the market about 10 years ago because of suspected renal toxicity.

-- By Jacqueline Weaver

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