Caffeine dependence

Caffeine is a commonplace central nervous system stimulant drug which occurs in nature as part of the coffee, tea, yerba mate, cocoa and other plants. It is also an additive in many consumer products, most notably beverages advertised as energy drinks and colas.

See also: Caffeine-induced anxiety disorder, caffeine-induced sleep disorder, and caffeinism
Caffeine dependence
Other namesCaffeine addiction
SpecialtyPsychiatry

Caffeine's mechanism of action is somewhat different from that of cocaine and the substituted amphetamines; caffeine blocks adenosine receptors A and A2A.[1] Adenosine is a by-product of cellular activity, and stimulation of adenosine receptors produces feelings of tiredness and the need to sleep. Caffeine's ability to block these receptors means the levels of the body's natural stimulants, dopamine and norepinephrine, continue at higher levels.

The Diagnostic and Statistical Manual of Mental Disorders describes four caffeine-related disorders including intoxication, withdrawal, anxiety, and sleep.[2]

Dependence

Mild physical dependence can result from excessive caffeine intake.[3] Caffeine addiction, or a pathological and compulsive form of use, has not been documented in humans.[3][4]

Studies have demonstrated that people who take in a minimum of 100 mg of caffeine per day (about the amount in one cup of coffee) can acquire a physical dependence that would trigger withdrawal symptoms that include headaches, muscle pain and stiffness, lethargy, nausea, vomiting, depressed mood, and marked irritability.[5] Professor Roland Griffiths, a professor of neurology at Johns Hopkins in Baltimore strongly believes that caffeine withdrawal should be classified as a psychological disorder.[5] His research suggested that withdrawal affects 50% of habitual coffee drinkers, beginning within 12–24 hours after cessation of caffeine intake, and peaking in 20–48 hours, lasting as long as 9 days.[4][6]

Continued exposure to caffeine leads the body to create more adenosine receptors in the central nervous system which makes it more sensitive to the effects of adenosine in two ways: It reduces the stimulatory effects of caffeine by increasing tolerance, and it increases the withdrawal symptoms of caffeine as the body becomes more sensitive to the effects of adenosine once caffeine intake stops. Caffeine tolerance develops very quickly. Tolerance to the sleep disruption effects of caffeine were seen after consumption of 400 mg of caffeine 3 times a day for 7 days, whereas complete tolerance was observed after consumption of 300 mg taken 3 times a day for 18 days.[7]

References
  1. Fisone, G, Borgkvist A, Usiello A (2004): Caffeine as a psychomotor stimulant: Mechanism of Action. Cellular and Molecular Life Sciences 61:857-872
  2. Addicott, Merideth A. (2014). "Caffeine Use Disorder: A Review of the Evidence and Future Implications". Current Addiction Reports. 1 (3): 186–192. doi:10.1007/s40429-014-0024-9. PMC 4115451. PMID 25089257.
  3. Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. p. 375. ISBN 9780071481274. Long-term caffeine use can lead to mild physical dependence. A withdrawal syndrome characterized by drowsiness, irritability, and headache typically lasts no longer than a day. True compulsive use of caffeine has not been documented.
  4. Hall, Harriet. "Caffeine Withdrawal Headaches". Science-Based Medicine. Retrieved 30 May 2019.
  5. Studeville, George (January 15, 2010). "Caffeine Addiction Is a Mental Disorder, Doctors Say". National Geographic.
  6. 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. doi:10.1007/s00213-004-2000-x. PMID 15448977.
  7. "Caffeine Pharmacology". News Medical.
Classification
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