Caffeine Psychosis

Caffeine Psychosis

Many people forget that continuously consuming caffeine can be very dangerous. Caffeine can be very powerful stimulant to the nervous system, that is why many people drink caffeinated beverages when they are sleepy or tired to wake themselves up. Many people also don’t know that you can overdoes on caffeine and taking over seven shots of expresso is considered an overdose. I remember reading several incidents where college students drank way to much coffee or soda causing them to overdose and end up in the hospital. When one overdoses on caffeine sometimes they can enter a caffeine-induced psychosis. A person must ingest at least 500 milligrams of caffeine within an hour in order to enter this state of psychosis. A caffeine-induced Psychosis is usually characterized with symptoms of “hallucinations, panic, mania, depression and severe mental illness.” Unfortunately many people who come into the hospital with a caffeine induced psychosis are misdiagnosed and spend many years in psychotherapy or in a hospital for the mentally ill, not knowing that it was the intake of too much caffeine that caused them to go “crazy”. Some people show signs of very violent behavior, irritability and twitching after entering this caffeine psychosis. Many have committed crimes of violence while under this psychosis but can not remember that it was their caffeine intake that caused them to act violently. Recently ABC news reported that a man used “driving while caffeinated” as his defense to a hit a run that occurred in Washington State. After several psychiatric evaluations and blood work experts say that 31-year-old Daniel Noble may have been in an induced caffeinated psychosis when the crime took place. Caffeine psychosis can often masquerade itself as a real, severe mental disease and many spend a lot of money trying to “cure” themselves of this disease. A person under this psychosis can successfully plead the insanity defense since they were under a psychosis when committing the violent or criminal acts they committed. Sources: http://www.stress-anxiety-depression.org/forum/caffeine-induced-psychosis-topic-70.html http://www.doctoryourself.com/caffeine_allergy.htmlhttp://abcnews.go.com/Health/MindMoodNews/man-caffeinated-psychosis-defense-hit-run/story?id=9306666

http://www.neulaw.org/blog/1050-neulaw-blog/1296-caffeine-psychosis

CAFFEINE-INDUCED PSYCHOSIS

Case Report

Caffeine-Induced Psychosis

Dawson W. Hedges c1, Fu Lye Woon and Scott P. Hoopes

ABSTRACT

As a competitive adenosine antagonist, caffeine affects dopamine transmission and has been reported to worsen psychosis in people with schizophrenia and to cause psychosis in otherwise healthy people. We report of case of apparent chronic caffeine-induced psychosis characterized by delusions and paranoia in a 47-year-old man with high caffeine intake. The psychosis resolved within 7 weeks after lowering caffeine intake without use of antipsychotic medication. Clinicians might consider the possibility of caffeinism when evaluating chronic psychosis.

Addressing Caffeine-induced Psychosis: A Clinical Perspective

Addressing Caffeine-induced Psychosis: A Clinical Perspective

Goiney, Christopher C. BS*; Gillaspie, Devin B. MS*; Alvarez Villalba, Clara L. MD

Abstract Introduction: Caffeine-induced psychosis is a rare entity with just 6 cases published in the medical literature. According to these cases, massive caffeine intake can precipitate psychosis.

Objectives: Authors reviewed the medical literature on caffeine-induced psychosis and its proposed neurobiological pathways. Methods: We performed a review on caffeine-induced psychosis using MEDLINE, Pubmed, and OVID with different word combinations including: “caffeine,” “psychosis,” “delusions,” “agitation,” “intoxication.” In addition, we present a case of a previously healthy 29-year-old man who developed an abrupt onset of paranoid delusions, thought disorganization, and bizarre behavior after increasing his caffeine intake to >1500 mg per day over a period of 2 days. During the psychotic episode, the patient accidentally shot himself in the chest and was rushed to the hospital. Thyroid tests, toxicology, blood, and urine work-up excluded other conditions that could have triggered the psychosis. There is no personal or family history of psychiatric illness or substance use. Furthermore, the patient and family denied any suicidal intention or psychiatric symptoms before this episode. Results: Our case supports the existing data on psychosis precipitated by excessive amounts of caffeine intake.

Conclusions: Caffeine-induced psychiatric disorders should be included in the differential diagnoses for patients presenting with psychotic symptoms. Overuse of coffee or other caffeine-containing beverages such as energy drinks should be investigated in these patients

Caffeine-Induced Psychosis

Abstract

As a competitive adenosine antagonist, caffeine affects dopamine transmission and has been reported to worsen psychosis in people with schizophrenia and to cause psychosis in otherwise healthy people. We report of case of apparent chronic caffeine-induced psychosis characterized by delusions and paranoia in a 47-year-old man with high caffeine intake. The psychosis resolved within 7 weeks after lowering caffeine intake without use of antipsychotic medication. Clinicians might consider the possibility of caffeinism when evaluating chronic psychosis.

Introduction

A competitive antagonist of adenosine receptors1 affecting adenosine A1 and A2A receptors2 and, possibly, benzodiazepine receptors,3 as well as an inhibitor of phosphodiesterase and catecholamine metabolism,4 caffeine is readily available from a variety of sources and is widely used by all age groups.5Possibly the most widely used psychoactive drug worldwide,4,6 caffeine use can cause physical dependence.7 In addition to producing stimulant-like effects,8 such as increasing alertness and reducing fatigue4 and increasing motor activity,2 caffeine can cause anxiety,9 agitation, and even aggression.10

Continue reading “Caffeine-Induced Psychosis”

Neuropsychiatric effects of caffeine

, ,

Caffeine-Induced Psychosis: Case Report

 By Dawson W. Hedges, MD, Fu Lye Woon, MA, and Scott P. Hoopes, MD

Case Report

FOCUS POINTS

• Caffeine use can cause depression, anxiety, agitation, and aggression.

• Caffeine may cause psychosis that when chronic may mimic other psychiatric conditions.

• Caffeinism should be considered in the differential diagnosis of psychosis.

Dr. Hedges is an assistant professor in the Department of Psychology and the Neuroscience Center at Brigham Young University in Provo, Utah. Mr. Woon is a doctoral student in clinical psychology in the Department of Psychology and the Neuroscience Center at Brigham Young University. Dr. Hoopes is an adjunct faculty member in the Department of Psychiatry at the University of Utah School of Medicine and in private practice in Boise, Idaho.

Faculty Disclosures: The authors do not have an affiliation with or financial interest in an organization that might pose a conflict of interest.

Submitted for publication: November 1, 2008; Accepted for publication: February 23, 2009.

Please direct all correspondence to: Dawson W. Hedges, MD, 1001 SWKT, Brigham Young University, Department of Psychology and the Neuroscience Center, Provo, UT 84602; Tel: 801-422-6357, Fax: 801-422-0602; E-mail:

ABSTRACT

As a competitive adenosine antagonist, caffeine affects dopamine transmission and has been reported to worsen psychosis in people with schizophrenia and to cause psychosis in otherwise healthy people.

We report of case of apparent chronic caffeine-induced psychosis characterized by delusions and paranoia in a 47-year-old man with high caffeine intake. The psychosis resolved within 7 weeks after lowering caffeine intake without use of antipsychotic medication. Clinicians might consider the possibility of caffeinism when evaluating chronic psychosis.

CASE REPORT

A 47-year-old successful male farmer with no history of psychiatric hospitalization presented with a 7-year history of depression, diminished sleep to as little as 4 hours/night, poor energy, explosive anger, decreased concentration, decreased appetite, anhedonia, and feeling of worthlessness.

Seven years before his first presentation, the patient had developed the conviction that people were plotting against him to drive him off of his farm and take his land. At least twice, when he had found dead livestock on his farm, the patient thought that it was part of the plot against him and would entertain no other possibilities.

The patient interpreted tire tracks in the driveway as belonging to the car of individuals trying to take his land, even though other more plausible possibilities existed. According to the patient’s wife, the subject interpreted many everyday occurrences as evidence of the plot.

Convinced of a plot against him, he installed surveillance cameras in his house and on his farm but never caught anything that would support his conviction that as part of the plot people were coming onto his farm at night. He became so preoccupied with the alleged plot that he neglected the business of the farm and eventually declared bankruptcy as a result. His preoccupation with the plot also led him to neglect the upkeep of his home, and he had his children taken from him because of unsanitary living conditions.

In addition to psychosis, the patient reported life-long difficulty sustaining attention, excessive talking, disorganization, distraction, and forgetfulness. He denied other features of anxiety and psychosis.

The patient reported drinking less than one case of beer annually. However, ~7 years before presentation, he had sharply increased his consumption of coffee from 10– 12 cups/day to ~36 cups/day, a change in coffee consumption corroborated by his wife who made much of the coffee for him at home. There was no history of psychosis before the increase in coffee consumption, but after the increased consumption, the patient developed paranoia. At presentation, the patient reported drinking >1 gallon of coffee/day.

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Psychotropic drug-related eosinophilia with systemic symptoms after acute caffeine ingestion.

Pediatrics. 2011 Jan;127(1):e235-8. Epub 2010 Dec 6.

Mahapatra S, Belgrad JL, Adeoye MA.

Department of Pediatrics, Lucile Packard Children’s Hospital, 725 Welch Rd, Palo Alto, CA 94304, USA. smahapatra@lpch.org

Abstract

Drug-related eosinophilia with systemic symptoms (DRESS) is a potentially life-threatening, multiorgan condition that can result from drug treatment. Antiepileptic medications have provided the best-studied link of any class of medications.

Here, we report the case of a 16-year-old boy with long-standing bipolar disorder who was chronically treated with aripiprazole and fluoxetine and developed DRESS syndrome after ingestion of high doses of caffeine.

His classic presentation with fever, morbilliform rash, lymphadenopathy, and visceral involvement, including leukocytosis, eosinophilia, and hepatitis, was consistent with this diagnosis.

Furthermore, the patient’s symptoms dramatically improved after corticosteroid therapy and discontinuation of all psychotropic medications. We propose that the development of DRESS syndrome is a net result of inconsistent medication adherence coupled with the ingestion of near-toxic doses of caffeine, which can lead to rhabdomyolysis and, through renal impairment, lead to the accumulation of toxic oxidative metabolites of either or both psychotropic medications.

We also present one of the few reported cases of caffeine-induced rhabdomyolysis and propose its role in the development of DRESS in this patient.

PMID: 21135003 [PubMed – indexed for MEDLINE]

Caffeine and psychiatric symptoms: a review.

J Okla State Med Assoc. 2004 Dec;97(12):538-42.
Broderick P, Benjamin AB.
University of Oklahoma, 2312 North Indiana Avenue, Oklahoma City, Oklahoma 73106, USA.
Abstract
Caffeine is a widely used psychoactive substance that has the potential to contribute to many psychiatric symptoms. This review article aims to address the specific research studies and case reports that relate caffeine to psychiatric symptoms.
Caffeine can cause anxiety symptoms in normal individuals, especially in vulnerable patients, like those with pre-existing anxiety disorders. Caffeine use is also associated with symptoms of depression due to either a self-medication theory, or a theory that caffeine itself causes changes in mood.
Psychosis can be induced in normal individuals ingesting caffeine at toxic doses, and psychotic symptoms can also be worsened in schizophrenic patients using caffeine. Sleep and symptoms of ADHD may be altered by caffeine as well. Prevention of caffeine-induced psychiatric symptoms is possible by recognizing, educating, and treating patients using a tapering approach.
PMID: 15732884 [PubMed – indexed for MEDLINE]

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