Caffeine withdrawal symptoms

Reading this with a cup of coffee in your hand? Well, you’re not alone. In North America, approximately 90 percent of adults say they drink a caffeinated beverage every day.

 

But, what happens when you stop?

 

After sudden caffeine cessation, withdrawal symptoms develop in a small portion of the population, according to a research paper by Jasvinder Chawla, M.D. and Amer Suleman, M.D.

 

The study notes that the effects of caffeine withdrawal are often mild and transient but typical symptoms include:

 

• headaches
• fatigue
• weakness
• drowsiness
• impaired concentration and work difficulty
• depression and or anxiety
• irritability
• increased muscle tension

 

Tremor, nausea, and vomiting can also occur in extreme cases of caffeine withdrawal.

 

When do withdrawal symptoms start?

Withdrawal symptoms generally begin 12-24 hours after sudden cessation of caffeine consumption and reach a peak after 24-48 hours, says Daniel Evatt, Ph.D., a psychiatry research fellow at the Johns Hopkins School of Medicine in Baltimore. 

 

For those more sensitive to caffeine, withdrawal symptoms can appear within three hours and last up to a week if no caffeine enters the body to abate withdrawal symptoms.

 

“The most common symptom we see in people who stop using caffeine is headache, and that’s only in about a half the population who abruptly quit,” says Evatt.

 

170 years of medical literature

Roland Griffiths, a professor of behavioral biology at Johns Hopkins University, co-authored a paper in Psychopharmacology that reviewed 170 years of caffeine withdrawal mentions in medical literature.

 

In 57 experimental and nine survey studies, 13 percent of research participants experienced significant distress or functional impairment. The most severe cases of caffeine withdrawal occurred in those subjects who consumed high doses of caffeine.

 

But the study also revealed that it takes only 100 mg of caffeine a day (the typical amount of caffeine in a moderate-strength 8-ounce serving of coffee) to experience withdrawal symptoms.

 

Griffiths’ study, published in 2004, concluded that caffeine withdrawal symptoms are serious enough to merit inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

 

As of the fourth edition of the DSM, caffeine withdrawal has not been included but caffeine-induced anxiety, sleep disorder and intoxication are included. The fifth edition will be released in 2013. A proposed revision to the DSM-V suggests that caffeine withdrawal may be included in the next edition.

 

Caffeine’s benefits overstated?

Evatt says that feelings of anxiety, irritability, depression, as well as sluggishness are all symptoms that are opposite of what the supposed benefits of caffeine offer. Evatt has found that to enjoy the benefits of caffeine, only a little bit is required.

 

“You can get the benefits in less than 100 milligrams,” says Evatt, also cautioning that above 300-400 mg per day of caffeine may lead to more serious withdrawal symptoms.  

 

Jack E. James, Ph.D., the editor-in-chief of the Journal of Caffeine Research, tells MNN via email that the beneficial effects of caffeine are inflated.

 

“The widely-held beliefs of superior performance and mood after caffeine consumption are simply due to a reversal of adverse withdrawal effects,” James writes.

 

“Overall, there is little evidence of caffeine having beneficial effects on performance or mood under conditions of long-term caffeine use as opposed to abstinence,” adds James, who had a study published in the New England Journal of Medicine concluding that even low to moderate consumption of caffeine resulted in half of the subjects experiencing headaches.

 

Advice for cutting back on caffeine?
According to Evatt, you should not quit cold turkey. Instead, reduce consumption by 25 percent every week and if your goal is total elimination, within three weeks you should be able to abstain.

 

As for the maximum amount of caffeine allowed per day, Evatt says it’s hard to pin down.

 

“Due to the massive differences in how people react and metabolize caffeine, it’s impossible to give one guideline,” says Evatt.

 

Decaf latte, anyone?