Caffeine Withdrawal Taken More Seriously

BALTIMORE -- 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.

Researchers at Johns Hopkins University reviewed 170 years of caffeine research and concluded that as little as one cup a day can lead to real addiction.

The study will result in caffeine withdrawal being included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, reported WBAL-TV in Baltimore.

Some coffee lovers know how difficult it is to kick the caffeine habit. Comedienne Ellen DeGeneres, appearing Wednesday on her television talk show, talked about her own attempts to kick caffeine to the curb.

"I'm tired, and I'm telling you, I'm not gonna harp on it because it's boring for those of you who don't know what I'm going through. If you want to try to do it with me, get off coffee with me so you can see what hell I'm in. Oh, it's so hard. I'm exhausted," DeGeneres said.

When people don't get their regular fix, withdrawal symptoms can range from headaches, fatigue and difficulty concentrating to feeling like they have the flu with nausea and muscle pain, the researchers said.

"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," said Dr. Roland Griffiths, a professor of psychiatry and neuroscience at Johns Hopkins.

The findings by Griffiths and colleague Dr. Laura Juliano, of American University, are published in the October 2004 issue of the journal Psychopharmacology.

In their review, the researchers identified 57 experimental studies and nine survey studies on caffeine withdrawal and examined each to assess the findings.

The researchers identified five clusters of common withdrawal symptoms, including:

• Headache
• Fatigue or drowsiness
• Depression and irritability
• Difficulty concentrating
• Flulike symptoms of nausea, vomiting and muscle pain or stiffness

In experimental studies, 50 percent of people on caffeine withdrawal had a headache, and 13 percent experienced distress or other symptoms that impaired their work.

The symptoms generally started 12 to 24 hours after stopping caffeine, with peak intensity between one and two days, and for a duration of two to nine days, according to the researchers.

In general, the severity of symptoms increased as the daily dose of caffeine increased, but abstinence from doses as low as 100 mg per day -- about one small cup of coffee -- also produced symptoms.

But the researchers offered what they called was good news for those who want 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," Griffiths said.

Study Abstract