Caffeine. Caffeine dependence
Last reviewed: 23.04.2024
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Caffeine, which has a mild psycho-stimulating effect, is a psychoactive substance that is most widely used in the world. It is present in soft drinks, coffee, tea, cocoa, chocolate and a number of prescription or non-prescription medicines. Caffeine is absorbed from the gastrointestinal tract and spreads rapidly across all tissues, easily penetrating the placental barrier. Many effects of caffeine can be explained by competitive antagonism to adenosine receptors. Adenosine, which is part of adenosine triphosphate (ATP) and nucleic acids, acts as a neuromodulator, affecting a number of metabolic functions in the central nervous system. Since adenosine usually reduces CNS activity, adenosine receptor antagonists (such as caffeine) have a stimulating effect.
Tolerance to the stimulating effect of caffeine develops rapidly. In double-blind studies, it is shown that a mild abstinence syndrome can cause a sudden cessation of intake of even 1-2 cups of coffee per day. Abstinence when caffeine is discontinued is manifested by a feeling of fatigue and drowsiness. At the termination of the use of high doses, headache, nausea, and rarely vomiting are possible. The possibility of developing an abstinence syndrome does not mean the formation of addiction. Few of the people who consumed caffeine reported loss of control over caffeine consumption or difficulties in reducing the dose or stopping it on their own. In this regard, caffeine is not included in the list of psychostimulants that cause dependence (DSM-IV).
Intoxication with high doses of caffeine can be expressed in irritability, agitation, insomnia, increased diuresis, tachycardia, muscle twitching. A high level of caffeine can enhance previously reported anxiety disorders or may be the cause of insomnia. In this regard, every patient with symptoms of anxiety should clarify the dose of caffeine consumed by him.
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