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

Caffeine dependence is a condition characterized by a set of criteria including tolerance, withdrawal symptoms, persistent desire or unsuccessful efforts to control use, and continued use despite knowledge of adverse consequences attributed to caffeine.[1] It can appear in physical dependence or psychological dependence, or both. Caffeine is one of the most common additives in many consumer products, including pills and beverages such as caffeinated alcoholic beverages, energy drinks, pain reliever medications, and colas. Caffeine is found naturally in plants such as coffee and tea and other plants. Studies have found that 89 percent of adults in the U.S. consume on average 200 mg of caffeine daily.[2] One area of concern that has been presented is the relationship between pregnancy and caffeine consumption. Repeated caffeine doses of 100mg appeared to result in smaller size at birth in newborns. When looking at birth weight however, caffeine consumption did not appear to make an impact.[3]

Dependence[edit]

See also: Caffeine § Dependence and withdrawal

Moderate physical dependence often arises from prolonged long-term caffeine use.[4] In the human body, caffeine blocks adenosine receptors A1 and A2A.[5] Adenosine is a by-product of cellular activity, the stimulation of adenosine receptors produces feelings of tiredness and a drive for sleep. Caffeine's ability to block these receptors means the levels of the body's natural stimulants, dopamine, and norepinephrine, continue at higher levels.

Continued exposure to caffeine prompts the body to create more adenosine-receptors in the central nervous system, which increases the body's adenosine sensitivity. This reduces the stimulatory effects of caffeine by increasing tolerance. It also causes the body to suffer withdrawal symptoms (such as headaches, fatigue, and irritability) if caffeine intake decreases.[6]

The Diagnostic and Statistical Manual of Mental Disorders describes four caffeine-related disorders including intoxication, withdrawal, anxiety, and sleep.[7]

Addiction vs. dependence[edit]

Caffeine use is classified as a dependence, not an addiction. For a drug to be considered addictive, it must activate the brain's reward circuit. Caffeine, like addictive drugs, enhances dopamine signaling in the brain (is eugeroic), but not enough to activate the brain's reward circuit like addictive substances cause severe psychological dependence such as cocaine, morphine, and nicotine.[8] Caffeine dependence forms due to caffeine antagonizing the adenosine A2A receptor,[9] effectively blocking adenosine from the adenosine receptor site. This delays the onset of drowsiness and releases dopamine.[10] As of right now, caffeine withdrawal qualifies as a psychiatric condition by the American Psychiatric Association, but caffeine-use disorder does not.[11]

Professor Roland R. Griffiths, a professor of neurology at Johns Hopkins in Baltimore, strongly believes that caffeine withdrawal should be classified as a psychological disorder.[12] His research suggests 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.[13][14] In another study, he concluded 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, including muscle pain and stiffness, nausea, vomiting, and depressed mood, and other symptoms.[12][6]

Physiological effects[edit]

Caffeine dependence can cause a host of physiological effects if caffeine consumption is not maintained. Commonly known caffeine withdrawal symptoms include headaches, fatigue, loss of focus, lack of motivation, mood swings, nausea, insomnia, dizziness, cardiac issues, hypertension, anxiety, and backache and joint pain; these can range in severity from mild to severe.[15] These symptoms may occur within 12–24 hours and can last two to nine days.[16][17][18]

Tests are still being done to get a better understanding of the effects that occur to people when they become dependent on different forms of caffeine to make it through the day. There has been research findings that suggest that the circadian cycle is not significantly changed under popular practices of caffeine consumption in the morning and during the afternoon.[19]

Children and Teenagers[edit]

According to the American Academy of Pediatrics (AAP), it is not recommended for individuals under the age of 18 to consume several caffeinated drinks in one day. If they were to consume caffeine, it is recommended to follow usage guidelines, to avoid overconsumption.[20] If they do not restrict their caffeine intake, they can become dependent on caffeine and without it suffer a variety of side effects. These include increase of heart rate and blood pressure, sleep disturbance, mood swings, and acid reflux. Caffeine's lasting effects on children's nervous and cardiovascular systems are currently unknown, and studies are still being conducted on it. Some research has suggested that caffeinated drinks should not be advertised to children as a primary audience.[21][22]

Pregnancy Effects[edit]

Pregnancy[edit]

If pregnant, it is recommended not to consume more than 200 mg of caffeine a day (though this is relative to the pregnant woman's weight).[23] If a pregnant woman consumes high levels of caffeine, it can result in low birth weight due to loss of blood flow to the placenta,[24] and could lead to health problems later in the child's life.[25] It can also result in premature labor, reduced fertility, and other reproductive issues. The American Pregnancy Association suggests "avoiding caffeine as much as possible" before and during pregnancy or discussing how to curtail dependency with a healthcare provider.[26]

Treatment[edit]

Understanding effective treatment strategies is crucial in managing caffeine dependence, a condition that has garnered increasing attention in recent years. A plethora of studies have surfaced aimed at reducing caffeine intake and alleviating withdrawal symptoms. One significant contribution comes from a comprehensive review and research agenda that undertook a thorough examination of caffeine use disorder.[1] This review not only discusses potential diagnostic criteria but also highlights the far-reaching implications for individuals struggling with caffeine dependency. The author characterizes caffeine as a widely consumed substance, yet one that is not immune to fostering dependency . Despite its generally recognized safety profile, clinical evidence suggests a concerning trend wherein users develop a reliance on caffeine, often struggling to curtail consumption despite recurring health concerns, such as cardiovascular issues and perinatal complications.[27]

Evidence -based treatment strategies offer a beacon of hope for individuals seeking to break free from caffeine dependency. These strategies encompass a spectrum of approaches, including gradual dose tapering, intermittent fasting, diligent monitoring of caffeine intake through journaling, and the incorporation of regular exercise coupled with professional counseling.[2]

Gradual dose tapering[edit]

One effective approach to managing caffeine dependence is gradual dose tapering, wherein individual gradually reduce their caffeine intake over time. This method allows the body to adjust to lower levels of caffeine gradually, minimizing withdrawals symptoms and discomfort . A study published in the journal of caffeine Research demonstration the efficacy of gradual dose tapering in reducing caffeine consumption among habitual users. Participants who followed a gradual tapering schedule experienced fewer withdrawal symptoms and were more successful in reducing their overall caffeine intake compared to those who abruptly stopped caffeine consumption.[3]

Intermittent fasting[edit]

Intermittent fasting, a dietary regimen that involves alternating periods of eating and fasting, has emerged as a potential strategy for managing caffeine dependence. Research suggest that intermittent fasting may help regulate caffeine intake by creating structure periods of abstaining from caffeine consumption. Additionally, intermittent fasting has been associated with improved metabolic health and cognitive function, which may support individuals in overcoming caffeine dependence. A study published in the Journal of Nutrition and Metabolism found that participants who practiced intermittent fasting reported decreased cravings and improved energy levels compared to those who did not follow a fasting regimen.

Professional counseling[edit]

Seeking professional counseling or therapy can also be beneficial for individuals struggling with caffeine dependence. Counseling sessions provide a supportive environment for individuals to explore the underlying reasons for their caffeine consumption habits and develop coping strategies to manage cravings and withdrawal symptoms. Cognitive behavioral therapy (CBT), in particular, has shown promise in treating substance use disorders, including caffeine dependence. A meta- analysis published in the Journal of Consulting and Clinical Psychology found that CBT interventions were effective n reducing caffeine consumption and improving psychological outcomes among individuals with caffeine dependence.

Incorporating regular exercise[edit]

Regular physical exercise has been shown to have numerous benefits for overall health and well-being, including aiding in the management of caffeine dependence. Engaging in regular exercise can help individuals reduce stress, improve mood, and promote better sleep quality, all of which may contribute to reducing reliance on caffeine as a stimulant.

It is important that while many adults consume caffeine on a daily basis, withdrawal symptoms may not manifest until 12-24 hours after cessation and can persist for as long as 2-9 days. such symptoms can significantly impact daily functioning, giving rise to fatigue, headaches, irritability, nausea, mood fluctuations, flu-like systems, and dizziness.[28]

References[edit]

  1. ^ Bernstein, Gail A; Carroll, Marilyn E; Thuras, Paul D; Cosgrove, Kelly P; Roth, Megan E (March 2002). "Caffeine dependence in teenagers". Drug and Alcohol Dependence. 66 (1): 1–6. doi:10.1016/S0376-8716(01)00181-8. PMID 11850129.
  2. ^ Fulgoni, Victor L; Keast, Debra R; Lieberman, Harris R (2015-05-01). "Trends in intake and sources of caffeine in the diets of US adults: 2001–2010". The American Journal of Clinical Nutrition. 101 (5): 1081–1087. doi:10.3945/ajcn.113.080077. ISSN 0002-9165. PMID 25832334. S2CID 22251069.
  3. ^ Soltani, Sanaz; Salari-Moghaddam, Asma; Saneei, Parvane; Askari, Mohammadreza; Larijani, Bagher; Azadbakht, Leila; Esmaillzadeh, Ahmad (2021-07-05). "Maternal caffeine consumption during pregnancy and risk of low birth weight: a dose–response meta-analysis of cohort studies". Critical Reviews in Food Science and Nutrition. 63 (2): 224–233. doi:10.1080/10408398.2021.1945532. ISSN 1040-8398. PMID 34224282. S2CID 235744429.
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  5. ^ Fisone, G, Borgkvist A, Usiello A (2004):  Caffeine as a psychomotor stimulant:  Mechanism of Action. Cellular and Molecular Life Sciences 61:857-872
  6. ^ a b Stroh, Michael. "Just one cup a day is enough to hook coffee drinkers". LA Times. Retrieved 15 August 2023.
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  24. ^ Sajadi-Ernazarova, Karima R.; Anderson, Jackie; Dhakal, Aayush; Hamilton, Richard J. (2020), "Caffeine Withdrawal", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 28613541, retrieved 2020-11-06
  25. ^ "Should I limit caffeine during pregnancy?". nhs.uk. 2018-06-27. Retrieved 2020-11-06.
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  27. ^ Rodda, Simone; Booth, Natalia; McKean, Jessica; Chung, Anita; Park, Jennifer Jiyun; Ware, Paul (July 2020). "Mechanisms for the reduction of caffeine consumption: What, how and why". Drug and Alcohol Dependence. 212: 108024. doi:10.1016/j.drugalcdep.2020.108024. PMID 32442750.
  28. ^ Juliano, Laura M.; Huntley, Edward D.; Harrell, Paul T.; Westerman, Ashley T. (August 2012). "Development of the Caffeine Withdrawal Symptom Questionnaire: Caffeine withdrawal symptoms cluster into 7 factors". Drug and Alcohol Dependence. 124 (3): 229–234. doi:10.1016/j.drugalcdep.2012.01.009. PMID 22341956.

External links[edit]

source: https://en.wikipedia.org/wiki/Caffeine_dependence