Researchers have identified the major symptoms associated with caffeine withdrawal. These begin with headache, followed by drowsiness or fatigue, irritability, difficulty in concentrating, muscle pain, nausea accompanied by vomiting. All these symptoms interfere with the ability to work and cause distress and depression among the individuals [7].

Symptoms usually show effect within 12 – 24 hours of withdrawal of caffeine. The intensity peaks within 1 – 2 days and the symptom lasts for as long as 2 – 9 days. It was also postulated that the severity of symptoms would heavily depend on the dosage of caffeine the individual was accustomed to. However, it has been noticed that those consuming as less as 100 mg of caffeine per day also suffered from symptoms upon its withdrawal [8].

Research studies have also underlined that, in order to avoid caffeine withdrawal symptoms, subjects have to go back to their daily cup of coffee. With inclusion of caffeine containing products, the negative effects of withdrawal just vanishes and they could get the perceived benefits of their morning cup of coffee.

• Pathologist

  Casual discussions at work with GPs and neurologists suggested all sorts of treatments, none of which made a great deal of difference, but it took a pathologist colleague who had suffered the same symptoms to identify the cause. [bmj.com]

• Aspiration

  The aim of these instructions is to decrease the risk of possible aspiration of gastric contents during sedation when protective reflexes may be impaired. [oralhealthgroup.com]

• Sore Throat

  I had a sore throat, runny nose, my body ached and my head hurt. I took the necessary steps to get better: I slept well, ate soup, drank tea and watched several episodes of New Girl. [hercampus.com]

• Muscle Rigidity

  Muscle rigidity : You may notice that your muscles become tense and/or rigid. Again, this is another counterintuitive response that people have reported. [mentalhealthdaily.com]

• Eye Irritation

  Health benefits of zinc is too much, but to mention some it cure down synonym, high blood pressure, psoriasis, eye irritation, acne and etc. It will promote better nervous stability and help with caffeine withdrawal symptoms. [homeremediesblog.com]

• Urinary Incontinence

  If you have urinary incontinence, you may experience a greater "urgency" to urinate after consuming a caffeinated beverage. You will need to monitor your reaction and tolerance to caffeine to determine how you are affected. [medicinenet.com]

• Headache

  Coffee seemed to abate the headache. This frequency (0.4%) should, clearly, be regarded as a minimum figure. Caffeine-withdrawal headache at the grassroots level may be a rather rare, generally vague, symptom-poor headache. [ncbi.nlm.nih.gov]

  This is further explained by the fact that upon administration of coffee the headaches gets eventually resolved. It occurs due to the ability of caffeine to constrict the blood vessels that is causing the headache. [symptoma.com]

• Generalized Tonic-Clonic Seizure

  On the third day after discontinuation a withdrawal syndrome characterized by headache and a generalized tonic-clonic seizure occurred. [ncbi.nlm.nih.gov]

• Sciatica

  The medical history included sleep apnea, depression, paranoid delusional disorder, insomnia, chronic pain from sciatica, and obesity (BMI 36.1 kg/m2). [oralhealthgroup.com]

• Intracranial Hemorrhage

  hemorrhage, space-occupying lesion of central nervous system, carbon monoxide poisoning, pre-eclampsia, hypertensive disorders, depression, anxiety, panic attacks, acute glaucoma, dehydration, analgesic or other substances abuse, and mood disorders. [ncbi.nlm.nih.gov]

• Meningism

  Evaluation The evaluation of patients presenting with symptoms of caffeine withdrawal should include an establishment of adequate differential diagnosis in order to exclude other clinically significant conditions, such as migraine headaches, meningitis [ncbi.nlm.nih.gov]

Caffeine withdrawal is now listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental disorders and lately has been defined as mental disorder since it significantly impairs the individual’s ability to optimally perform his/her daily activities.

Researchers suggest that in order to be diagnosed with caffeine withdrawal, an individual must experience at least 3 out of 5 symptoms within 24 hours from the elimination of the stimulant. The symptoms include: headache, drowsiness / fatigue, irritability / depressed mood, poor concentration and flu-like symptoms. These are some of the most common symptoms experienced by all; however, if these worsen to such an extent to be able to cause distress and interfere with the individual's daily work, an intervention might be needed.

The speed with which caffeine is metabolized and removed from the system varies from one individual to another. For some it takes as long as 8 hours to metabolize caffeine, whereas in some it takes just about 2 hours [9].

Diagnosis can be made based on the individual’s history of caffeine intake from all possible sources.

Individuals who wish to remove that caffeine from life are advised to follow gradual elimination. This can be done by gradually decreasing the amount of caffeine they add to their regular cup. This can be mixed with decaffeinated coffee and eventually the proportion of caffeine can be reduced. During the withdrawal phase, support from family and friends would also be of great help.

Prognosis of the condition will depend on how long caffeine has been withdrawn from the daily diet. In initial stages, individuals would experience mild headache which gradually gets better once the stimulant is taken. However, in many instances, symptoms can even get worse and necessary medical intervention becomes mandatory.

Symptoms of caffeine withdrawal occur when individuals either reduce or eliminate the caffeine stimulant from their daily routine. For individuals addicted to consume coffee on daily basis, even a slight change or reduction in the amount can give rise to mild headache or discomfort. It has been seen that individuals who do not maintain their amount of caffeine consumption per day are at an increased risk of suffering from the unpleasant symptoms. Individuals who are on the point of detoxifying their body from caffeine are also potential candidates of experiencing symptoms of caffeine withdrawal [2].

It has been estimated that about 90% of individuals across the globe consume coffee on a daily basis. About 400 mg of caffeine has been found to be safe for adult population. Caffeine withdrawal symptoms are experienced by almost 50% of individuals who decide to stay away from the stimulant [3].

Studies have shown that about 280 mg of caffeine is daily consumed by individuals in USA, with a higher intake reported amongst the European population. Caffeine is not ingested from coffee alone, but from tea, caffeinated energy and soft drinks as well [3].

Side effect of caffeine withdrawal is most commonly presented by development of headaches in individuals who actually want to avoid it. Onset of headache upon withdrawal of caffeine occurs as a result of enhanced response of adenosine to neurotransmitter in brain. Large amounts of adenosine causes the blood vessels to dilate and in turn causes sudden drop in blood pressure.

Therefore, there is a strong association between dilation of blood vessels due to increased levels of adenosine upon caffeine withdrawal. This is further explained by the fact that upon administration of coffee the headaches gets eventually resolved. It occurs due to the ability of caffeine to constrict the blood vessels that is causing the headache [5].

Caffeine has structure similar to that of adenosine, which binds with the nerve receptors and inhibits their transmission, thus acting as a stimulant. In such situations, the body produces more adenosine to carry out its normal functioning. Therefore, when caffeine is eliminated, more number of receptors is available to bind to adenosine which in turn gives rise to unpleasant symptoms [6].

The best way to prevent caffeine withdrawal symptoms is to avoid going cold turkey. Gradual reduction of caffeine either by reducing the volume or by substituting caffeine with decaffeinated powder would help in easy elimination [10].

According to several research trials conducted on coffee consumption, it was postulated that occurrence of headache or uneasiness for not getting the regular cup of coffee in the morning can be a sign of caffeine withdrawal – a disorder in making. Excessive consumption of caffeine has been significantly linked to development of bladder cancer. Several risks have been associated with consumption of coffee. However, the beverage has various protective effects as well [1].

Definition: Caffeine withdrawal is a condition wherein individuals wish to eliminate caffeine from their diet. Recently, it has been considered  a form of mental condition, as during the elimination period several unpleasant symptoms are experienced that significantly hamper the individual’s ability to participate properly in their work.

Cause: Symptoms of caffeine withdrawal occur when individuals withdraw caffeine from their diet. Even a slight change or reduction in amount of caffeine can give rise to various unpleasant symptoms.

Symptoms: Individuals who practice caffeine withdrawal suffer from headache, nausea, vomiting, irritability, poor / decreased concentration and flu-like symptoms.

Diagnosis: Diagnosis is made based on the patient’s pattern of caffeine consumption. A careful history is gathered followed by study of signs and symptoms.

Treatment: Clinicians suggest staged reduction of caffeine on a gradual basis instead of adopting the sudden strategy. Staged reduction would allow an absolute elimination of caffeine after a few days.

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