Caffeinism

Last updated
Caffeinism
Other namesCaffeine overdose
Specialty Toxicology, psychiatry, neurology

Caffeinism is a state of intoxication caused by excessive consumption of caffeine. This intoxication covers a variety of unpleasant physical and mental symptoms associated with the consumption of excessive amounts of caffeine. [1]

Contents

Caffeine is considered one of the most widely consumed drugs around the world. Around 80% of the world population consumes caffeine in one form or another. [2] It is found in coffee, tea, caffeinated alcoholic drinks, cocoa, chocolate, soft drinks, especially cola, and is an important component of energy drinks and other dietary supplements. [1]

Caffeine is also an ingredient of several medications, many of them over-the-counter and prescription drugs. The consensus is to consider caffeine a drug with pharmacological effects acting throughout the body.

Signs and symptoms

Primary symptoms of caffeine intoxication Main symptoms of Caffeine overdose.svg
Primary symptoms of caffeine intoxication

In moderate doses, caffeine is used to reduce physical fatigue, to prevent drowsiness and sleep, and to maintain and restore mental alertness and wakefulness in the short term. However, at higher doses, these stimulatory effects can become excessive and lead to a wide range of unpleasant symptoms including a dysphoric physical and mental state that is labeled caffeinism and is also known colloquially as "coffee nerves" or "caffeine jitters." These symptoms including nervousness, irritability, restlessness, insomnia, headaches, and palpitations after caffeine use. [4]

Caffeinism usually occurs when consumption of caffeine reaches 1–1.5 grams (0.035–0.053 oz) per day. [5] For reference, a brewed 8oz (227ml) cup of coffee contains ~95 mg of caffeine (per USDA). [6]

According to the Diagnostic and Statistical Manual of Mental Disorders, caffeine overdose can result in a state of excessive stimulation of the central nervous system and the essential feature of Caffeine Intoxication is the recent consumption of caffeine. This diagnosis requires the presence of at least five signs or symptoms, from a list of 12, that develop during or shortly after caffeine use. [7] This syndrome regularly happens when a person ingested large amounts of caffeine from any source (e.g., more than 400–500 mg at a time).

The signs and symptoms are divided into one group that can appear after an intake of as little as 100 mg of caffeine (roughly the amount contained in a cup of brewed coffee) and another group of symptoms that appear at higher levels of intake (more than 1 g per day). Low-dose symptoms include

  1. restlessness,
  2. nervousness,
  3. excitement,
  4. insomnia,
  5. flushed face,
  6. diuresis (increased urination), and
  7. gastrointestinal disturbance.

Symptoms associated with high doses of caffeine include

  1. muscle twitching,
  2. rambling flow of thought and speech,
  3. tachycardia and cardiac arrhythmia,
  4. periods of inexhaustibility, and
  5. psychomotor agitation, [1]
  6. anorexia (loss of appetite),
  7. seizures,
  8. death.

The symptoms of caffeine intoxication are comparable to the symptoms of overdoses of other stimulants. [3] In cases of much larger overdoses, mania, depression, lapses in judgment, disorientation, disinhibition, delusions, weight loss, loss of appetite, hallucinations, or psychosis may occur. [8] [9]

Death can occur as a result of caffeine overdose. [10] [11] The LD50 of caffeine in humans is dependent on individual sensitivity, but is estimated to be 150–200 milligrams per kilogram of body mass (75–100 cups of coffee for a 70 kilogram adult). [12] A number of fatalities have been caused by overdoses of readily available powdered caffeine supplements, for which the estimated lethal amount is less than a tablespoon. [13] The lethal dose is lower in individuals whose ability to metabolize caffeine is impaired due to genetics or chronic liver disease. [14] A death was reported in a man with liver cirrhosis who overdosed on caffeinated mints. [15] [16] [17]

Treatment

Treatment of mild caffeine intoxication is directed toward symptom relief; severe intoxication may require peritoneal dialysis, hemodialysis, or hemofiltration. [3] Control of caffeine intake requires awareness of the caffeine content of caffeinated beverages, over-the-counter drugs, and other sources of caffeine in the diet. Such information is not easy to obtain. The content of brewed beverages such as coffee and tea varies greatly based on the method of preparation. [18]

There is no standard value for "a cup of coffee." The caffeine content of cola drinks and most energy drinks can be difficult to determine, because in many cases the labels do not indicate the dose per serving. Caffeine doses in these beverages range from 20 to 30 mg in some soft drinks, up to 350 mg or more in some energy drinks. Although some Internet web sites report caffeine content for beverages, official lists are not available and the number of brands continually grows. [1]

Attempting to abruptly discontinue all consumption of caffeine-containing products from the diet is not usually recommended. The person could suffer from severe symptoms of caffeine withdrawal including headaches, fatigue, and difficulty concentrating. It is recommended that the person reduces caffeine consumption gradually to avoid withdrawal as attempts to suddenly discontinue all caffeine consumption are frequently abandoned due to the severity of the withdrawal symptoms. [1] [18]

Epidemiology

Little is known about the prevalence of caffeinism in the general population. Although most people are familiar with the disorder, it probably remains underdiagnosed, because patients are rarely questioned about the use of caffeine. [2]

See also

Related Research Articles

<span class="mw-page-title-main">Caffeine</span> Central nervous system stimulant

Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class and is the most commonly consumed psychoactive substance globally. It is mainly used for its eugeroic, ergogenic, or nootropic (cognitive-enhancing) properties. Caffeine acts by blocking binding of adenosine at a number of adenosine receptor types, inhibiting the centrally depressant effects of adenosine and enhancing the release of acetylcholine. Caffeine has a three-dimensional structure similar to that of adenosine, which allows it to bind and block its receptors. Caffeine also increases cyclic AMP levels through nonselective inhibition of phosphodiesterase, increases calcium release from intracellular stores, and antagonizes GABA receptors, although these mechanisms typically occur at concentrations beyond usual human consumption.

<span class="mw-page-title-main">Alcohol intoxication</span> Behavioural and physical changes due to the consumption of alcohol

Alcohol intoxication, commonly described in higher doses as drunkenness or inebriation, and known in overdose as alcohol poisoning, is the behavior and physical effects caused by recent consumption of alcohol. The technical term intoxication in common speech may suggest that a large amount of alcohol has been consumed, leading to accompanying physical symptoms and deleterious health effects. Mild intoxication is mostly referred to by slang terms such as tipsy or buzzed. In addition to the toxicity of ethanol, the main psychoactive component of alcoholic beverages, other physiological symptoms may arise from the activity of acetaldehyde, a metabolite of alcohol. These effects may not arise until hours after ingestion and may contribute to a condition colloquially known as a hangover.

<span class="mw-page-title-main">Energy drink</span> Beverage containing stimulants

An energy drink is a type of functional beverage containing stimulant compounds, usually caffeine, which is marketed as providing mental and physical stimulation. They may or may not be carbonated and may also contain sugar, other sweeteners, or herbal extracts, among numerous other possible ingredients.

Stimulant psychosis is a mental disorder characterized by psychotic symptoms. It involves and typically occurs following an overdose or several day binge on psychostimulants, although it can occur in the course of stimulant therapy, particularly at higher doses. One study reported occurrences at regularly prescribed doses in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy. Methamphetamine psychosis, or long-term effects of stimulant use in the brain, depend upon genetics and may persist for some time.

<span class="mw-page-title-main">Caffeinated drink</span> Type of drink

A caffeinated drink, or caffeinated beverage, is a drink that contains caffeine, a stimulant that is legal practically all over the world. Some are naturally caffeinated while others have caffeine added as an ingredient.

The health effects of tea have been studied throughout human history. In clinical research conducted over the early 21st century, tea has been studied extensively for its potential to lower the risk of human diseases, but there is no good scientific evidence to support any therapeutic uses other than possibly increasing alertness, an effect caused by caffeine in the tea leaves.

<span class="mw-page-title-main">Caffeine dependence</span> Medical condition

Caffeine dependence is a condition characterized by a set of criteria, including tolerance, withdrawal symptoms, persistent desire or unsuccessful efforts to control use, and continued use despite knowledge of adverse consequences attributed to caffeine. It can appear in physical dependence or psychological dependence, or both. Caffeine is one of the most common additives in many consumer products, including pills and beverages such as caffeinated alcoholic beverages, energy drinks, pain reliever medications, and colas. Caffeine is found naturally in various plants such as coffee and tea. Studies have found that 89 percent of adults in the U.S. consume on average 200 mg of caffeine daily. One area of concern that has been presented is the relationship between pregnancy and caffeine consumption. Repeated caffeine doses of 100 mg appeared to result in smaller size at birth in newborns. When looking at birth weight however, caffeine consumption did not appear to make an impact.

The health effects of coffee include various possible health benefits and health risks.

Caffeine-induced sleep disorder was a psychiatric disorder identified as resulting from overconsumption of the stimulant caffeine.

<span class="mw-page-title-main">Effect of caffeine on memory</span>

Caffeine is a bitter, white crystalline xanthine alkaloid that acts as a psychoactive stimulant drug. It can have both positive and negative effects on different aspects of memory.

Bromism is the syndrome which results from the long-term consumption of bromine, usually through bromine-based sedatives such as potassium bromide and lithium bromide. Bromism was once a very common disorder, being responsible for 5 to 10% of psychiatric hospital admissions, but is now uncommon since bromide was withdrawn from clinical use in many countries and was severely restricted in others.

<span class="mw-page-title-main">Low caffeine coffee</span> Type of coffee

Low caffeine coffee is a term that is used by coffee producers to describe coffee that has not been subjected to a process of decaffeination, but is substantially lower in caffeine than average coffee. Samples of coffee vary widely in caffeine levels due to many factors, some well documented and some not fully understood, such as the action of soil, water levels and sunlight. Low caffeine coffees are typically created by assaying caffeine levels of different bean lots and selecting the best flavor profile from the lots that are naturally lowest in caffeine.

<span class="mw-page-title-main">Caffeinated alcoholic drink</span> Drink containing both alcohol and caffeine

A caffeinated alcoholic drink is a drink that contains both alcohol and a significant amount of caffeine. Caffeine, a stimulant, masks some of the depressant effects of alcohol. However, in 2010 and 2011, this type of drink faced criticism for posing health risks to its drinkers. In some places there is a ban on caffeinated alcoholic drinks.

<span class="mw-page-title-main">Ban on caffeinated alcoholic drinks in the United States</span>

The 17 November 2010 United States ban on caffeinated alcoholic drinks is a ban which prevents the marketing and distribution of any prepackaged caffeinated alcoholic drink.

<span class="mw-page-title-main">Alcohol (drug)</span> Active ingredient in fermented drinks

Alcohol, sometimes referred to by the chemical name ethanol, is the second most consumed psychoactive drug globally behind caffeine, and alcohol use disorders are the most prevalent of all substance use disorders worldwide. Alcohol is a central nervous system (CNS) depressant, decreasing electrical activity of neurons in the brain. The World Health Organization (WHO) classifies alcohol as a toxic, psychoactive, dependence-producing, and carcinogenic substance.

Caffeine-induced anxiety disorder is a subclass of the DSM-5 diagnosis of substance/medication-induced anxiety disorder.

Stimulant use disorder is a type of substance use disorder where the use of stimulants caused clinically significant impairment or distress. It is defined in the DSM-5 as "the continued use of amphetamine-type substances, cocaine, or other stimulants leading to clinically significant impairment or distress, from mild to severe". These psychoactive drugs, known as stimulants, are among the most widely used drugs in the world today, although not all stimulants can induce addiction.

Caffeine-induced psychosis is a relatively rare phenomenon that can occur in otherwise healthy people. Overuse of caffeine may also worsen psychosis in people suffering from schizophrenia. It is characterized by psychotic symptoms such as delusions, paranoia, and hallucinations. This can happen with ingestion of high doses of caffeine, or when caffeine is chronically abused, but the actual evidence is currently limited.

This page is a list of terms related to the psychoactive drug alcohol.

References

  1. 1 2 3 4 5 Stolerman, Ian P. (2010). Encyclopedia of Psychopharmacology (Online-Ausg. ed.). Berlin, Heidelberg: Springer-Verlag Berlin Heidelberg. pp. 261–264. ISBN   978-3-540-68706-1.
  2. 1 2 Iancu, I; Strous, RD (February 2006). "Caffeine intoxication: history, clinical features, diagnosis and treatment". Harefuah. 145 (2): 147–51, 163–4. PMID   16509422.
  3. 1 2 3 "Caffeine (Systemic)". MedlinePlus. 25 May 2000. Archived from the original on 23 February 2007. Retrieved 3 August 2009.
  4. ↑ Iancu I, Olmer A, Strous RD (2007). "Caffeinism: History, clinical features, diagnosis, and treatment". In Smith BD, Gupta U, Gupta BS (eds.). Caffeine and Activation Theory: Effects on Health and Behavior. CRC Press. pp. 331–344. ISBN   978-0-8493-7102-8 . Retrieved 15 January 2014.
  5. ↑ Winston AP, Hardwick E, Jaberi N (2005). "Neuropsychiatric effects of caffeine". Advances in Psychiatric Treatment. 11 (6): 432–439. doi: 10.1192/apt.11.6.432 .
  6. ↑ "FoodData Central". ndb.nal.usda.gov. Retrieved 2020-10-02.
  7. ↑ American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). American Psychiatric Association. ISBN   978-0-89042-062-1.
  8. ↑ "Caffeine overdose". MedlinePlus. 4 April 2006. Retrieved 3 August 2009.
  9. ↑ Verkhratsky A (January 2005). "Physiology and pathophysiology of the calcium store in the endoplasmic reticulum of neurons". Physiological Reviews. 85 (1): 201–79. doi:10.1152/physrev.00004.2004. PMID   15618481. S2CID   11820734.
  10. ↑ Holmgren P, Nordén-Pettersson L, Ahlner J (January 2004). "Caffeine fatalities – four case reports". Forensic Science International. 139 (1): 71–3. doi:10.1016/j.forsciint.2003.09.019. PMID   14687776.
  11. ↑ "FDA Consumer Advice on Powdered Pure Caffeine". FDA. Retrieved 20 August 2014.
  12. ↑ Peters JM (1967). "Factors Affecting Caffeine Toxicity: A Review of the Literature". The Journal of Clinical Pharmacology and the Journal of New Drugs. 7 (3): 131–141. doi:10.1002/j.1552-4604.1967.tb00034.x. Archived from the original on 12 January 2012.
  13. ↑ Murray Carpenter (18 May 2015). "Caffeine powder poses deadly risks". New York Times. Retrieved 18 May 2015.
  14. ↑ Rodopoulos N, Wisén O, Norman A (May 1995). "Caffeine metabolism in patients with chronic liver disease". Scandinavian Journal of Clinical and Laboratory Investigation. 55 (3): 229–42. doi:10.3109/00365519509089618. PMID   7638557.
  15. ↑ Cheston P, Smith L (11 October 2013). "Man died after overdosing on caffeine mints". The Independent. Retrieved 13 October 2013.
  16. ↑ Prynne M (11 October 2013). "Warning over caffeine sweets after father dies from overdose". The Telegraph. Archived from the original on 11 October 2013. Retrieved 13 October 2013.
  17. ↑ Fricker M (12 October 2013). "John Jackson: Family of dad who died from caffeine overdose after eating MINTS want them removed from sale". Daily Mirror. Retrieved 13 October 2013.
  18. 1 2 Haenel, H. (1992). "J. E. James: Caffeine and Health. 432 Seiten. Academic Press, London, San Diego, New York u. a. Preis: 29,50 £; 59,95 $". Food/Nahrung. 36 (4): 431. doi:10.1002/food.19920360453.
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