Caffeine Withdrawal Recognized as a Disorder

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I have given up caffeine and developed some bad muscle cramps. Wouldn't you

know its caffeine withdrawal. Nice to know not every pain I have is CMT

related

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Caffeine Withdrawal Recognized as a Disorder

September 2004

If you missed your morning coffee and now you have a headache and difficulty

concentrating, you might be able to blame it on caffeine withdrawal. In

general, the more caffeine consumed, the more severe withdrawal symptoms are

likely to be, but as little as one standard cup of coffee a day can produce

caffeine addiction, according to a s Hopkins study that reviewed over 170

years of caffeine withdrawal research.

Results of the s Hopkins study should result in caffeine withdrawal

being included in the next edition of the DSM, the Diagnostic and Statistical

Manual of Mental Disorders, considered the bible of mental disorders, and the

diagnosis should be updated in the World Health Organization's ICD, the

International Statistical Classification of Diseases and Related Health

Problems.

" Caffeine is the world's most commonly used stimulant, and it's cheap and

readily available so people can maintain their use of caffeine quite easily, "

says Roland Griffiths, Ph.D., professor of psychiatry and neuroscience at

s Hopkins. " The latest research demonstrates, however, that when people

don't

get their usual dose they can suffer a range of withdrawal symptoms,

including headache, fatigue, difficulty concentrating. They may even feel like

they

have the flu with nausea and muscle pain. "

Griffiths, and colleague no, Ph.D., of American University

published these findings in the October 2004 issue of the journal

Psychopharmacology, available online now.

" Despite more than a century and a half of investigation into caffeine

withdrawal, doctors and other health professionals have had no scientifically

based framework for diagnosing the syndrome, " says Griffiths. " Our goal was to

critically review the literature regarding caffeine withdrawal to validate the

symptoms and signs of illness associated with it, and to determine how often

withdrawal produced clinically significant distress. "

In their review, the researchers identified 57 experimental studies and nine

survey studies on caffeine withdrawal, and examined each to assess the

validity of the reported findings.

The researchers identified five clusters of common withdrawal symptoms:

headache; fatigue or drowsiness; dysphoric mood including depression and

irritability; difficulty concentrating; and flu-like symptoms of nausea,

vomiting,

and muscle pain or stiffness. In experimental studies, 50 percent of people

experienced headache and 13 percent had clinically significant distress or

functional impairment--for example, severe headache and other symptoms

incompatible with working. Typically, onset of symptoms occurred 12 to 24 hours

after

stopping caffeine, with peak intensity between one and two days, and for a

duration of two to nine days. In general, the incidence or severity of symptoms

increased with increases in daily dose, but abstinence from doses as low as 100

milligrams per day, or about one small cup of coffee, also produced

symptoms.

The research also showed that avoidance of caffeine withdrawal symptoms

motivates regular use of caffeine. For example, the satisfying feelings and

perceived benefits that many coffee users experience from their morning coffee

appear to be a simple reversal of the negative effects of caffeine withdrawal

after overnight abstinence.

But there is good news for those wishing to quit caffeine: A simple,

stepwise approach can often eliminate the need for a " fix " without suffering the

most severe withdrawal symptoms.

" We teach a systematic method of gradually reducing caffeine consumption

over time by substituting decaffeinated or non-caffeinated products. Using such

a method allows people to reduce or eliminate withdrawal symptoms, " says

Griffiths.

According to the report, caffeine is the most widely used behaviorally

active drug in the world. In North America, 80 percent to 90 percent of adults

report regular use of caffeine. Average daily intake of caffeine among caffeine

consumers in the United States is about 280 milligrams, or about one to two

mugs of coffee or three to five bottles of soft drink, with higher intakes

estimated in some European countries. In the United States, coffee and soft

drinks are the most common sources of caffeine, with almost half of caffeine

consumers ingesting caffeine from multiple sources, including tea.

The study was funded in part by the National Institute on Drug Abuse.

_s Hopkins University Department of Neuroscience_

(http://neuroscience.jhu.edu/peopledetail.asp?ID=48)