Caffeinism

Caffeinism is poisoning resulting from intake of caffeine, whether via coffee, tea, chocolate, soft drinks, over-the-counter medications, or other caffeine-containing products. Its symptoms are both physiological and psychological. The amount of caffeine needed to generate caffeinism varies with the individual, but may be less than one soda or cup of coffee a day.

Caffeinism mimics a number of mental illnesses, from anxiety and bipolar disorder to schizophrenia and psychosis. This, along with the fact that it may destroy the victim's self-awareness, rendering him oblivious to his symptoms, can make it difficult to diagnose. Doctors unfamiliar with caffeinism may mistake it for one of the disorders above.

In acute cases, the patient descends into a psychosis more commonly associated with illicit drugs, which medication is powerless to cure as long as he remains intoxicated:

"Caffeine-induced psychosis, whether it be delirium, manic depression, schizophrenia, or merely an anxiety syndrome, in most cases will be hard to differentiate from other organic or non-organic psychoses....The treatment for caffeine-induced psychosis is to withhold further caffeine."

Clinical Management of Poisoning and Drug Overdose, 3rd ed., 1998 Michael W. Shannon, MD, MPH, Director, Lead and Toxicology Clinic, The Children's Hospital Boston; Professor of Pediatrics, Harvard Medical School; Lester M. Haddad, MD, Clinical Professor in Family Medicine, Medical University of South Carolina; Bon Secours St. Francis Xavier Hospital; James F. Winchester, MD, Professor of Medicine, Division of Nephrology, Georgetown University Medical Center

Drs. JE James and KP Stirling, in The British Journal of Addiction: "Although infrequently diagnosed, caffeinism is thought to afflict as many as one person in ten of the population."

Clinical nutritionist Stephen Cherniske: "For five years I worked in a team practice with physicians and psychotherapists. Often, the psychological evaluation would include one or more anxiety syndromes, and the recommendation was for counseling. I would point out that the person was consuming excessive amounts of caffeine and request a trial month off caffeine prior to therapy sessions. In about 50% of cases, the anxiety syndrome would resolve with caffeine withdrawal alone."

"In over a decade of practice as a clinical nutritionist, I have seen firsthand, with thousands of clients, that caffeine is a health hazard. Anxiety, muscle aches, PMS, headaches....However, if that's all caffeine has done to you, you're lucky. What about people misdiagnosed as neurotic or even psychotic, who spend years and small fortunes in psychotherapy--all because no one asked them about their caffeine intake?"

R. Gregory Lande, DO, FACN, Deputy and Director of Professional Services, William S. Hall Psychiatric Institute, University of South Carolina: "Diagnosis of any caffeine-related disorder begins with clinical awareness. Beverage caffeine is such a common component of social activity that its consideration as a psychostimulant often is neglected.... Too many clinical histories fail to record caffeine use."

"In rare cases where an individual's dose exceeds 1 gram per day [less than twice the dosage discovered in some 16 oz. Starbucks brews], the picture changes. Gross muscle tremors, highly disorganized speech, and possible arrhythmias herald a more sinister outcome."

Drs. DC Mackay and JW Rollins, Journal of the Royal Naval Medical Service, 1989: "[When caffeine is taken in excess], anxiety-related symptoms become increasingly apparent. A case of caffeinism, which presented as a paranoid delusion, is reported as an extreme example of this. A study of 60 hospital inpatients revealed that about 40% of them consumed sufficient caffeine to produce symptoms of caffeinism."

Sanford Bolton, PhD and Gary Null, M.S., Journal of Orthomolecular Psychiatry: "Recently published studies and reports of personal observations have shown without doubt that caffeine abuse (caffeinism) may result in a syndrome which resembles and may be confused or confounded with true psychotic states. This may lead to misdiagnosis and mistreatment. A question arises from the varied reports of caffeine consumption in psychiatric populations: Does caffeine stimulate psychosis or does psychosis stimulate caffeine consumption?"

Dr. Sidney Kaye, Institute of Legal Medicine: "The symptoms vary with acquired or inborn tolerance, but in general the patients may complain of [among other symptoms] nervousness, restlessness, silliness, elation, euphoria, confusion, disorientation, excitation, and even violent behavior with wild, inanic screaming, kicking and biting, progressing to semi-stupor."

"Coffee overindulgence is overlooked many times because the bizarre symptoms may resemble and masquerade as an organic or mental disease....But what a feeling of relief to both physician and patient to see the symptoms completely disappear on the physician's order to stop drinking coffee."

Calvin Thrash, MD: "Thousands are in mental institutions today because of no greater matter than that of the use of caffeine. Psychiatrists are now publishing articles indicating that there are numerous cases of depression and anxiety in mental institutions, who need no other treatment than to be taken off caffeine.

"However, the use of caffeine is so traditional and firmly entrenched that it is almost impossible to remove caffeinated drinks from the diet of patients in the mental institutions. Soft drink machines, coffee dispensers, and the traditional coffee break are common pastimes in mental institutions, and with those who are mentally ill at home."

Caffeinism has also been defined as the addiction to caffeine.

External link

• CaffeineWeb.com: Caffeinism's Mimicry of Mental Illness
• University of California – Berkeley – UHS