Treatment of caffeine toxicity with esmolol

We present the case of a 58-year-old woman who ingested more than 35 g of caffeine in a suicide attempt. She manifested all the clinical symptoms and signs of caffeine toxicity. Esmolol, an ultrashort-acting beta 1-selective antagonist, controlled her multiple dysrhythmias and symptoms of sympathetic nervous system hyperstimulation. We suggest the use of esmolol for treatment of dysrhythmias secondary to caffeine toxicity; to the best of our knowledge, the use of esmolol has not been reported for this purpose.