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Home » Caffeine Withdrawal

  • Clinical Disorders

Caffeine Withdrawal

  • - Written by admin
  • on August 3, 2021
Caffeine Withdrawal

Table of Contents

Overview

The presence of caffeine in various foods and beverages alongside the acceptance and encouragement of its use as part of social norms has led to its widespread use making it the most widely consumed drug in the world.

The effects of caffeine can be experienced shortly after its ingestion. An adenosine antagonist, it leads to elevated energy levels and alertness. Low to moderate doses of caffeine can produce happiness and sociability, resulting in an overall increase in well-being. However, higher doses of caffeine can lead to deleterious effects such as anxiousness, nervousness, jitters, and more.

Regular use of caffeine often produces a dependence that goes unnoticed by many due to its availability and acceptance in society. This often elicits a pattern of sustained use, building tolerance, and facing withdrawal upon termination of use.

Those individuals who regularly consume caffeine may start to build up a tolerance for its effects, leading to a gradual increase in the dosage consumed. This can have harmful effects if unmoderated. Likewise, abruptly terminating the consumption of caffeine can lead to the manifestation of withdrawal symptoms that might interfere with daily functioning and cause distress.

Signs and Symptoms

Caffeine withdrawal is a recognized medical diagnosis. The symptoms of caffeine withdrawal must be preceded by a prolonged (regular caffeine use of up to 400 mg of caffeine, doses higher than 400 mg are potentially unsafe) daily use of caffeine.

The symptoms include:

  1. Headache
  2. Fatigue or drowsiness
  3. Depressed mood or irritability
  4. Difficulty concentrating
  5. Flu-like symptoms
  6. Decreased motivation
  7. Feeling foggy-headed
  8. Confusion/bewilderment
  9. Total mood disturbance
  10. Increased night-time sleep duration/quality

These symptoms can be observed after abrupt cessation of caffeine use following sustained use of caffeine. Symptoms of caffeine withdrawal may also present themselves in cases where individuals consume amounts lower than their usual dosages.

Risk Factors

Individuals who heavily use caffeine are at risk of experiencing caffeine withdrawal. This commonly includes individuals living with mental disorders, including but not limited to:

  • Those with eating disorders
  • Smokers
  • Prisoners
  • Drug and alcohol abusers

While there is a lack of data available on the prevalence of caffeine withdrawal in the general population, a reported 50% of people who abstained from caffeine for a 24-hour duration experience headache and one more symptoms. Of those who attempted to permanently stop caffeine use, 70% reported experiencing one or more symptoms including functional impairment.

The unavailability of caffeine is the leading environmental risk factor for caffeine withdrawal. In spite of the legal status of caffeine, there are incidences when it may not be available, such as under medical circumstances (preceding or following surgery or along with other medication), pregnancy, hospitalization, religious observances, travel, war, and participation in research (usually medical in nature). By inhibiting the use of caffeine in certain circumstances, a foundation for caffeine withdrawal can be laid.

Diagnosis

The essential diagnostic feature to consider during the determination of caffeine withdrawal is the presence of characteristic withdrawal symptoms that present themselves after the abrupt cessation or substantial reduction of caffeine consumption.

The Diagnostic and Statistical Manual 5 states the following diagnostic criteria for caffeine withdrawal:

A.    Prolonged daily use of caffeine.

B.    Abrupt cessation of or reduction in caffeine use, followed within 24 hours by three (or more) of the following signs or symptoms:

  • Headache
  • Marked fatigue or drowsiness
  • Dysphoric mood, depressed mood, or irritability
  • Difficulty in concentrating
  • Flu-like symptoms (nausea, vomiting, or muscle pain/stiffness)

C.    The signs and symptoms in Criterion B cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

D.    The signs or symptoms are not associated with the physiological effects of another medical condition (e.g. migraine, viral illness) and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

The predominant feature of caffeine withdrawal is a headache, which may be mild to moderate or severe as it develops, throbbing and sensitive to movement.

Since caffeine is widely used, present in a large array of foods and beverages, and has been assimilated into social culture through various norms, individuals are likely to be unaware of their dependence on the drug. It is likely, under this circumstance, for symptoms of caffeine withdrawal to be attributed to other conditions such as flu or migraine.

It is also likely for caffeine withdrawal to occur when individuals have abstained from food or beverage intake for prolonged periods of time (such as during travel or before surgery).

Treatment

Treatment for caffeine withdrawal is usually provided by primary healthcare providers such as general physicians or nurse practitioners.

Since the symptoms of caffeine withdrawal tend to pass after a certain period of time, they may not require particular intervention if they are manageable. However, symptoms that affect functionality may be treated with analgesics.

Following the experience of caffeine withdrawal, it is suggested to break the cycle of consumption, tolerance, and withdrawal. This is a common pattern observed in occurrences of substance dependence. There is often scepticism within the individuals on how attributable the use of caffeine is to symptoms. There must be thorough education regarding the effects of caffeine, including clinical manifestations and caffeine dependence. Individuals should be encouraged to notice how much of their diet includes items containing caffeine.

This may be followed with a discontinuation program. It is not recommended for the individuals to quit caffeine at once altogether, but rather gradually reduce intake till it reaches moderate levels and is unlikely to cause dependence.

Differential Diagnosis

1. Other medical disorders and medical side effects: Several disorders should be considered in the differential diagnosis of caffeine withdrawal. Caffeine withdrawal can mimic migraine and other headache disorders, viral illnesses, sinus conditions, tension, other drug withdrawal states and medication side effects. The final determination of caffeine withdrawal should rest on a determination of the pattern and amount consumed, the time interval between caffeine abstinence and onset of symptoms, and the particular clinical features presented by the individual. A challenge dose of caffeine followed by symptom remission may be used to confirm the diagnosis

Comorbidity

Caffeine withdrawal may be associated with major depressive disorder, generalized anxiety disorder, panic disorder, antisocial personality disorder in adults, moderate to severe alcohol use disorder, and cannabis and cocaine use.

Specialist

Caffeine withdrawal can be diagnosed and treated by primary healthcare providers, such as general physicians.

In Conclusion

An extra dose of caffeine has its psychological and physical effects, but what happens when abruptly stop consuming caffeine? Our body has immense adjustment abilities. It adjusts our bodily function according to our caffeine intake and starts responding accordingly. When caffeine intake is abruptly stopped, it has an impact on psychological and bodily functions. 

Individuals who experience withdrawal symptoms should consult a professional and get therapy that will help them exercise self-control. Therapy helps in reducing the severity of the symptoms and also a possible relapse. 

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Table of Contents

Frequently Asked Questions

Is caffeine bad for health?

Caffeine has many health benefits, including lower risk of Parkinsonโ€™s and Alzheimerโ€™s, better liver functioning, and more. However, if consumed in excess, caffeine can have detrimental effects and cause anxiousness, headaches, and hypertension to name a few. It is important to moderate your caffeine intake.ย 

Can drinking coffee make me jittery?

Caffeinated coffee can sometimes cause jitters and restlessness if consumed in excess, or if you do not frequently consume that amount of caffeine. Once the caffeine leaves your system, you should feel fine. Try to drink decaffeinated coffee if the symptoms persist.ย 

I always feel tired hours after drinking caffeine. Is this a sign of fatigue as a withdrawal symptom?

Caffeine is an adenosine antagonist, which means it leads to higher energy levels and alertness. However, it can be common to experience tiredness when the caffeine leaves the system.

Is caffeine withdrawal affected by genetics?

As with most conditions, genetic factors do have some influence on the susceptibility to caffeine withdrawal. However, there has been no conclusive evidence linking particular genes to the condition.

What kind of cultural factors can bring about caffeine withdrawal?

Individuals who habitually consume caffeine in the form of tea, coffee, or other foods and beverages, may abstain from it while observing fasts for religious purposes. Fasts are observed during holy events such as Ramadan for Muslim communities or Yom Kippur for Jewish communities as ways of celebrating, reflecting on, and renewing faith. Refraining from the consumption of caffeine during this may bring about caffeine withdrawal symptoms. This can often be avoided or managed by gradually reducing the consumption of caffeine leading up to the beginning of the fasting period.ย 

How long do the symptoms of caffeine withdrawal last?

Caffeine withdrawal symptoms tend to develop between 12-24 hours after the last dose of caffeine was consumed and may last for about 2-9 days. The peak of the symptoms is felt between 20-48 hours. There is a possibility of caffeine withdrawal headaches lasting for up to 21 days.ย 

How can I differentiate between a migraine and a caffeine withdrawal headache?

Caffeine withdrawal symptoms are likely to be misattributed to a variety of causes. It is important to note that caffeine withdrawal symptoms follow abrupt cessation or substantial reduction in caffeine intake.

Should caffeine withdrawal be treated by consuming caffeine?

ย It is not suggested to consume high doses of caffeine to combat effects of caffeine withdrawal, because it is likely to lead to a pattern of caffeine dependence. However, you may phase out the use of caffeine by gradually reducing the amount you consume.

Can painkillers be used to treat caffeine withdrawal headaches?

In cases of severe headaches that interfere with functionality, doctors may prescribe the temporary use of painkillers. It is important to be careful with the use of painkillers because they might contain caffeine as well.ย 

How do I quit caffeine if I am facing caffeine withdrawal symptoms?

Caffeine intake cessation should be done gradually in order to avoid symptoms of withdrawal. Start by slowly reducing your caffeine intake, and consume caffeine more intermittently in order to avoid caffeine withdrawal.

References

  1. ย  ย  American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5ยฎ). American Psychiatric Pub.
From <https://scholar.google.com/scholar_lookup?title=Diagnostic+and+Statistical+Manual+of+Mental+Disorders,+Fifth+Edition.&publication_year=2013&#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AkrxECAc5pscJ%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den ย 
  1. ย  ย  Juliano, L. M., & Griffiths, R. R. (2004). A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology, 176(1), 1-29.
From <https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=A+critical+review+of+caffeine+withdrawal%3A+empirical+validation+of+symptoms+and+signs%2C+incidence%2C+severity%2C+and+associated+features&btnG=#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AqDZ-adrFU7oJ%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den> ย  ย 
  1. ย  ย  Greden, J. F., Victor, B. S., Fontaine, P., & Lubetsky, M. (1980). Caffeine-withdrawal headache: a clinical profile. Psychosomatics, 21(5), 411-418.
From <https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Caffeine-withdrawal+headache%3A+A+clinical+profile&btnG=#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AL2ibf_mKRL8J%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den> ย 
  1. ย  ย  de Mejia, E. G., & Ramirez-Mares, M. V. (2014). Impact of caffeine and coffee on our health. Trends in Endocrinology & Metabolism, 25(10), 489-492.
From <https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Impact+of+caffeine+and+coffee+on+our+health&btnG=#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AdvOJwrFp8yYJ%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den> ย 
  1. Hughes, J. R. (1992). Clinical importance of caffeine withdrawal.
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