caffeinism

File:Main symptoms of Caffeine overdose.svg

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.{{cite book|chapter=Caffeinism: History, clinical features, diagnosis, and treatment |chapter-url=https://books.google.com/books?id=sm2ZySXTm7oC&pg=PA331 |pages=331–344 |title=Caffeine and Activation Theory: Effects on Health and Behavior |veditors=Smith BD, Gupta U, Gupta BS |year=2007 |publisher=CRC Press |isbn=978-0-8493-7102-8 |vauthors=Iancu I, Olmer A, Strous RD |accessdate=15 January 2014}}

Caffeinism usually occurs when consumption of caffeine reaches {{convert|1|–|1.5|g}} per day.{{cite journal|title=Neuropsychiatric effects of caffeine |vauthors=Winston AP, Hardwick E, Jaberi N |journal=Advances in Psychiatric Treatment |year=2005 |pages=432–439 |doi=10.1192/apt.11.6.432 |volume=11 |issue=6|doi-access=free }} For reference, a brewed 8oz (227ml) cup of coffee contains ~95 mg of caffeine (per USDA).{{Cite web|title=FoodData Central|url=https://fdc.nal.usda.gov/fdc-app.html#/food-details/789337/nutrients|access-date=2020-10-02|website=ndb.nal.usda.gov}}

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.{{cite book |title=Diagnostic and Statistical Manual of Mental Disorders |edition=4th |publisher=American Psychiatric Association |year=1994 |isbn=978-0-89042-062-1 |author=American Psychiatric Association |url-access=registration |url=https://archive.org/details/diagnosticstatis00amer_0 }} 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,
6. anorexia (loss of appetite),
7. seizures,
8. death.

The symptoms of caffeine intoxication are comparable to the symptoms of overdoses of other stimulants.{{cite web|title=Caffeine (Systemic) |publisher=MedlinePlus |date=25 May 2000 |url=https://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html |archiveurl=https://web.archive.org/web/20070223063601/http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html |archivedate=23 February 2007 |accessdate=3 August 2009}} In cases of much larger overdoses, mania, depression, lapses in judgment, disorientation, disinhibition, delusions, weight loss, loss of appetite, hallucinations, or psychosis may occur.{{cite web|title=Caffeine overdose |publisher=MedlinePlus |date=4 April 2006 |url=https://www.nlm.nih.gov/medlineplus/ency/article/002579.htm |accessdate=3 August 2009}}{{cite journal | vauthors = Verkhratsky A | s2cid = 11820734 | title = Physiology and pathophysiology of the calcium store in the endoplasmic reticulum of neurons | journal = Physiological Reviews | volume = 85 | issue = 1 | pages = 201–79 | date = January 2005 | pmid = 15618481 | doi = 10.1152/physrev.00004.2004 }}

Death can occur as a result of caffeine overdose.{{cite journal | vauthors = Holmgren P, Nordén-Pettersson L, Ahlner J | title = Caffeine fatalities – four case reports | journal = Forensic Science International | volume = 139 | issue = 1 | pages = 71–3 | date = January 2004 | pmid = 14687776 | doi = 10.1016/j.forsciint.2003.09.019 }}{{cite web|title=FDA Consumer Advice on Powdered Pure Caffeine|url=https://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm405787.htm|archive-url=https://web.archive.org/web/20140718211300/http://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm405787.htm|url-status=dead|archive-date=July 18, 2014|website=FDA|accessdate=20 August 2014}} The LD₅₀ of caffeine in humans is dependent on individual sensitivity, but is estimated to be 150–200 milligrams per kilogram of body mass ({{not a typo|75–100 cups}} of coffee for a 70 kilogram adult).{{cite journal |title=Factors Affecting Caffeine Toxicity: A Review of the Literature |author=Peters JM |journal=The Journal of Clinical Pharmacology and the Journal of New Drugs |year=1967 |issue=3 |pages=131–141 |url=http://jcp.sagepub.com/content/7/3/131.extract |doi=10.1002/j.1552-4604.1967.tb00034.x |volume=7 |url-status=dead |archiveurl=https://web.archive.org/web/20120112134847/http://jcp.sagepub.com/content/7/3/131.extract |archivedate=12 January 2012 |df=dmy-all |url-access=subscription }} 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.{{cite web|title=Caffeine powder poses deadly risks |author=Murray Carpenter |work=New York Times |date=18 May 2015 |url=http://well.blogs.nytimes.com/2015/05/18/caffeine-powder-poses-deadly-risks-2 |accessdate=18 May 2015}} The lethal dose is lower in individuals whose ability to metabolize caffeine is impaired due to genetics or chronic liver disease.{{cite journal | vauthors = Rodopoulos N, Wisén O, Norman A | title = Caffeine metabolism in patients with chronic liver disease | journal = Scandinavian Journal of Clinical and Laboratory Investigation | volume = 55 | issue = 3 | pages = 229–42 | date = May 1995 | pmid = 7638557 | doi = 10.3109/00365519509089618 }} A death was reported in a man with liver cirrhosis who overdosed on caffeinated mints.{{cite news|url=https://www.independent.co.uk/news/uk/home-news/man-died-after-overdosing-on-caffeine-mints-8874964.html |title=Man died after overdosing on caffeine mints |vauthors=Cheston P, Smith L |date=11 October 2013 |newspaper=The Independent |accessdate=13 October 2013}}{{cite news|url=https://www.telegraph.co.uk/health/healthnews/10371921/Warning-over-caffeine-sweets-after-father-dies-from-overdose.html |archive-url=https://web.archive.org/web/20131011113121/http://www.telegraph.co.uk/health/healthnews/10371921/Warning-over-caffeine-sweets-after-father-dies-from-overdose.html |url-status=dead |archive-date=11 October 2013 |title=Warning over caffeine sweets after father dies from overdose |author=Prynne M |date=11 October 2013 |newspaper=The Telegraph |accessdate=13 October 2013}}{{cite web|url=https://www.mirror.co.uk/news/uk-news/john-jackson-family-dad-who-2363193 |title=John Jackson: Family of dad who died from caffeine overdose after eating MINTS want them removed from sale |author=Fricker M |date=12 October 2013 |website=Daily Mirror |accessdate=13 October 2013}}

Treatment of mild caffeine intoxication is directed toward symptom relief; severe intoxication may require peritoneal dialysis, hemodialysis, or hemofiltration. 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.{{cite journal|last1=Haenel|first1=H.|title=J. E. James: Caffeine and Health. 432 Seiten. Academic Press, London, San Diego, New York u. a. Preis: 29,50 £; 59,95 $|journal=Food/Nahrung|date=1992|volume=36|issue=4|page=431|doi=10.1002/food.19920360453}}

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 websites report caffeine content for beverages, official lists are not available and the number of brands continually grows.

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.

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.

• Caffeine-induced anxiety disorder
• Caffeine-induced psychosis
• Caffeine-induced sleep disorder
• Decaffeination
• Effect of caffeine on memory

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{{Psychoactive substance use}}

Category:Caffeine

Category:Intoxication