Caffeine Withdrawal

Excerpt

Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class and is one of the most widely used drugs in the world. Unlike other psychoactive drugs, it is legal, cheap, and not regulated in almost all parts of the world. Individuals who habitually drink caffeine-contained beverages may develop a physical, emotional, and psychological dependence on it and may experience a caffeine withdrawal syndrome after abrupt cessation of caffeine intake. Multiple studies have demonstrated that caffeine-withdrawal syndrome is a clinically relevant entity and is included in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013).

Physicians working in the emergency departments (ED) and the hospital must be familiar with this syndrome when they encounter patients with relevant symptoms, as they overlap with symptoms such as anxiety, depression, mood disorders, insomnia. They also can be the cause of abnormal vital signs, such as tachycardia, increased respiratory rate, and low or elevated blood pressure, and as such, can present a diagnostic challenge and/or be a cause of unnecessary workup in ED.