Anxiety or Caffeinism: A Diagnostic Dilemma

¹ Assistant Professor of Psychiatry, University of Michigan Medical Center, Ann Arbor, Mich. 48104

The author reports that high intake of caffeine ("caffeinism") can produce symptoms that are indistinguishable from those of anxiety neurosis, such as nervouness, irritability, tremulousness, occasional muscle twitchings, insomnia, sensory disturbances, tachypnea, palpitations, flushing, arrhythmias, diuresis, and gastrointestinal disturbances. The caffeine withdrawal syndrome and the headache associated with it may also mimic anxiety. Patients with caffeinism will generally be identified only by routine inquiry into their caffeine intake. The psychiatrist should especially suspect caffeinism in patients who do not respond to psychopharmacological agents or who have psychophysiological complaints and recurrent headaches, chronic coffee-drinking patients on inpatient psychiatric services, and "hyperkinetic" children. Three case reports illustrate the syndrome.

This article has been cited by other articles:

				C. B. Norager, M. B. Jensen, M. R. Madsen, and S. Laurberg Caffeine improves endurance in 75-yr-old citizens: a randomized, double-blind, placebo-controlled, crossover study J Appl Physiol, December 1, 2005; 99(6): 2302 - 2306. [Abstract] [Full Text] [PDF]

				A. P. Winston, E. Hardwick, and N. Jaberi Neuropsychiatric effects of caffeine Adv. Psychiatr. Treat., November 1, 2005; 11(6): 432 - 439. [Abstract] [Full Text] [PDF]

				B. B. Fredholm, K. Battig, J. Holmen, A. Nehlig, and E. E. Zvartau Actions of Caffeine in the Brain with Special Reference to Factors That Contribute to Its Widespread Use Pharmacol. Rev., March 1, 1999; 51(1): 83 - 133. [Abstract] [Full Text] [PDF]

				G. M. Etherton and M. S. Kochar Coffee: Facts and Controversies Arch Fam Med, March 1, 1993; 2(3): 317 - 322. [Abstract] [PDF]

				M. Bruce, N. Scott, P. Shine, and M. Lader Anxiogenic Effects of Caffeine in Patients With Anxiety Disorders Arch Gen Psychiatry, November 1, 1992; 49(11): 867 - 869. [Abstract] [PDF]

				D. S. Charney, G. R. Heninger, and P. I. Jatlow Increased Anxiogenic Effects of Caffeine in Panic Disorders Arch Gen Psychiatry, March 1, 1985; 42(3): 233 - 243. [Abstract] [PDF]

				J.-P. Boulenger, T. W. Uhde, E. A. Wolff III, and R. M. Post Increased Sensitivity to Caffeine in Patients With Panic Disorders: Preliminary Evidence Arch Gen Psychiatry, November 1, 1984; 41(11): 1067 - 1071. [Abstract] [PDF]

				J. L. Rapoport, C. J. Berg, D. R. Ismond, T. P. Zahn, and A. Neims Behavioral Effects of Caffeine in Children: Relationship Between Dietary Choice and Effects of Caffeine Challenge Arch Gen Psychiatry, November 1, 1984; 41(11): 1073 - 1079. [Abstract] [PDF]

				R. Lubit and B. Russett The Effects of Drugs on Decision-Making Journal of Conflict Resolution, March 1, 1984; 28(1): 85 - 102. [Abstract]

				B. White, C. Lincoln, N. Pearce, R Reeb, and C Vaida Anxiety and muscle tension as consequences of caffeine withdrawal Science, September 26, 1980; 209(4464): 1547 - 1548. [Abstract] [PDF]

				W.A. G. MacCallum Excess Coffee and Anxiety States International Journal of Social Psychiatry, September 1, 1979; 25(3): 209 - 210. [PDF]

				R. M. Gilbert Tea Toxicity JAMA, September 27, 1976; 236(13): 1452 - 1452. [Abstract] [PDF]

				W Revelle, P Amaral, and S Turriff Introversion/extroversion, time stress, and caffeine: effect on verbal performance Science, April 9, 1976; 192(4235): 149 - 150. [Abstract] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 1974 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us