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Caffeine. Caffeine addiction
Last reviewed: 07.07.2025
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Caffeine, a mild psychostimulant, is the most widely used psychoactive substance in the world. It is present in soft drinks, coffee, tea, cocoa, chocolate, and a variety of prescription and over-the-counter medications. Caffeine is absorbed from the gastrointestinal tract and is rapidly distributed throughout all tissues, readily crossing the placental barrier. Many of caffeine's effects may be due to competitive antagonism at adenosine receptors. Adenosine, a component of adenosine triphosphate (ATP) and nucleic acids, acts as a neuromodulator, affecting a variety of metabolic functions in the central nervous system. Because adenosine typically reduces CNS activity, adenosine receptor antagonists (such as caffeine) have a stimulant effect.
Tolerance to the stimulating effect of caffeine develops quickly. Double-blind studies have shown that a mild withdrawal syndrome can be caused by sudden cessation of even 1-2 cups of coffee per day. Withdrawal symptoms when stopping caffeine intake include fatigue and drowsiness. When stopping high doses, headache, nausea, and, less commonly, vomiting are possible. The possibility of developing withdrawal symptoms does not necessarily mean that an addiction has developed. Few people who use caffeine report loss of control over caffeine intake or difficulty in reducing the dose or stopping its use voluntarily. For this reason, caffeine is not included in the list of psychostimulants that cause addiction (DSM-IV).
Intoxication with high doses of caffeine may manifest itself in irritability, agitation, insomnia, increased diuresis, tachycardia, and muscle twitching. High levels of caffeine may aggravate previously noted anxiety disorders or may be the cause of insomnia. In this regard, each patient with anxiety symptoms should be asked about the dose of caffeine consumed.
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