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Caffeine intoxication: when the addiction gets serious

Caffeine intoxication is listed under the “Caffeine-Related Disorders” in the American Psychiatric Association’s Diagnostic Statistical Manual, 5th Edition (DSM-5). The diagnostic criterion for caffeine intoxication includes a recent consumption of caffeine in a high dose. A high dose according to the DSM-5 is 250 mg. Coffee, tea, cocoa, cola beverages, caffeine powder, over the counter pain relievers, as well as diet pills all contain caffeine.

Caffeine powder is a psychoactive stimulant called trimethylxanthine and is a part of the xanthine family; it’s very dangerous and can be deadly. This is why the FDA is concerned about pure caffeine being sold over the Internet. A single teaspoon of pure caffeine is roughly the equivalent to 25 cups of coffee. Symptoms of overdose to pure caffeine include an erratic heartbeat, seizures and death (FDA 2014). Like other drugs, people can build a tolerance to caffeine and become used to drinking more than what is considered a safe amount to consume. Body mass, weight and diet are factors that can affect the over-consumption of caffeine.

Caffeine is considered a psychoactive substance because it has the capability of contributing to many different psychiatric symptoms. Caffeine can cause symptoms of anxiety in people that don’t have an anxiety disorder, as well exacerbate symptoms of other mental illnesses and personality disorders (Broderick; Benjamin 2004).

High doses of caffeine can induce manic, psychotic and depressive symptoms, as well as anxiety. People who suffer from mental health disorders such as obsessive compulsive disorder (OCD), panic disorder and social anxiety disorder are particularly sensitive to caffeine (Biociências 2010).

A study conducted among psychiatric inpatients showed that out of 83 hospitalized adult psychiatric individuals, 22 percent reported being high caffeine consumers (750 mg or more per day). They scored greater on the State-Trait Anxiety Index and the Beck Depression Scale, compared to moderate and low consumers (Greden; Fontaine; Lubetsky; Chamberlin 1978).

Caffeine intoxication disorder

According to the DSM-5, signs of a caffeine intoxication disorder would have to cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Additionally, the intoxication could not be attributed to any particular medical condition or better explained by any type of mental disorder or intoxication of any other particular substance.

In order for a caffeine intoxication disorder to be present, five or more of the following signs or symptoms must occur shortly after the caffeine use:

  • Restlessness
  • Nervousness
  • Caffeine withdrawal
  • Excitement
  • Insomnia
  • Flushed face
  • Diuresis
  • Gastrointestinal disturbance
  • Muscle twitching
  • Rambling flow of thought and speech
  • Tachycardia or cardiac arrhythmia
  • Periods of inexhaustibility
  • Psychomotor agitation

Caffeine withdrawal

As with other substances if a person abuse caffeine they are at risk of encountering withdrawal. Caffeine withdrawal is listed in the DSM-5 as a mental disorder and can cause very uncomfortable symptoms. Studies show that if three or more of the following symptoms are experienced after 24 hours of drinking caffeine in the form of teas, coffees, diet pills or any food source containing caffeine, they would be classified as symptoms of caffeine withdrawal (DSM-5). Symptoms that would identify that someone is going through caffeine withdrawal would include:

  • Headache
  • Marked fatigue or drowsiness
  • Dysphoric mood
  • Depressed mood
  • Irritability
  • Difficulty concentrating
  • Flu-like symptoms such as nausea, vomiting or muscle stiffness or pain

While caffeine can be good in very small amounts in coffee or tea, abusing it is a dangerous and harmful act. For those struggling with caffeine addiction it is best to find help and a treatment program as soon as possible. If you or a loved one would like more information on caffeine intoxication or addiction to caffeine products, you can call the Recovery Helpline at 855-441-4405.

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