Caffeine Intoxication and Addiction

Holly Pohler


Journal for Nurse Practitioners. 2010;6(1):49-52. 

In This Article

Caffeinism and Dependence

Caffeine meets all the requirements for being an addictive substance, including dependence, tolerance, and withdrawal. Caffeinism is a syndrome resulting from the chronic consumption of caffeine and addiction. The symptoms include nervous irritability, tremulousness, occasional muscle twitching, sensory disturbances, tachypnea, palpitation, flushing, arhythmias, diuresis, and gastrointestinal disturbances. Patients may present with generalized anxiety or depression. Because many do not view caffeine as addictive, patients may not think to provide a careful caffeine history. If not prompted by the nurse practitioner (NP), the potential for misdiagnosis exists. Withdrawal of caffeine may be an onerous task. Following an orderly progression, headache is often the most common initial complaint. This becomes evident within the first 12 to 24 hours after termination of caffeine. Additional symptoms include irritability, fatigue, dysphoric mood, difficulty concentrating/decreased cognitive performance, depression, and muscle aches and stiffness. Peak withdrawal effects are anticipated to occur 20 to 48 hours after removal of caffeine. The total duration of the withdrawal syndrome ranges between 2 days to 1 week.[14] Withdrawal is not limited to adults. Adolescents and children have also been reported to suffer from withdrawal effects. The incidence of caffeine addiction and withdrawal may increase as energy drinks are increasingly targeted to this population.

Caffeine should be removed from the diet gradually. Tapering a patient's daily consumption over a period of time may decrease the likelihood of withdrawal symptoms or reduce their severity. One strategy may be to begin mixing 1/2 energy drink with 1/2 non-caffeinated beverage, the ultimate goal being to move the patient toward replacing high caffeine energy drinks with healthier options such as water, whole fruit juices, or caffeine-free beverages. Referral to a dietician may provide that extra support for those in need of additional guidance.


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