We’ve all probably had that one coffee drink (or carbonated beverage) too many, at that point in a slog of a day where we’ve gone and imbibed a Red Bull or Grande coffee against our better judgment.
According to a new edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders out last week (DSM, or in this case, DSM-5), that sort of excessive caffeine intake can lead to a condition known as “caffeine intoxication,” except it’s nothing like the sort of blissful stupor we tend to associate with that other sort of intoxication.
If you’ve had more than 250 mg of caffeine (two to three cups of brewed coffee) and experienced five or more of the following symptoms, says the guide, you’ve probably been caffeine-buzzed: restlessness, nervousness, excitement, insomnia, flushed face, diuresis (having to pee a lot), gastrointestinal disturbance, muscle twitching, rambling flow of thought and speech, tachycardia or cardiac arrhythmia, periods of inexhaustibility or psychomotor agitation (unintentional motion, say, rapidly bouncing one leg).
This disorder, as it’s described in both the older DSM-IV and new DSM-5, falls under the heading “Caffeine-Related Disorders,” but in DSM-5, that section includes a new entry: caffeine withdrawal. According to DSM-5, symptoms of caffeine withdrawal include fatigue, headache and difficulty focusing.
“Caffeine is a drug, a mild stimulant, which is used by almost everybody on a daily basis,” said Dr. Charles O’Brien, who chairs the Substance-Related Disorder Work Group for DSM-5 (via New York Post). “But it does have a letdown afterwards. If you drink a lot of coffee, at least two or three [236 ml] cups at a time, there will be a rebound or withdrawal effect.”
Anyone who’s binged on caffeine then stopped, cold turkey, knows the withdrawal symptoms are anything but make-believe — the headaches alone can be excruciating. The question some are asking is whether it belongs in a guide devoted to mental disorders (or, for that matter, whether caffeine intoxication does).
“The symptoms of caffeine withdrawal are transitory, they take care of themselves,” said clinical psychologist Robin Rosenberg (via International Science Times), noting that the effects are temporary. “It’s just a natural response to stopping caffeine, and it clears up on its own in short order.”
DSM-5 work-group member Alan J. Budney attempted to address the controversy back in December 2011, when caffeine withdrawal was announced as being “recommended for inclusion” in the revised guide.
“We feel that there is enough data to support a caffeine-withdrawal syndrome,” said Budney. “There are enough people who go into withdrawal — that if they don’t get caffeine, it becomes a real syndrome and can affect work, sleep, or whatever they need to do. So we’re suggesting that it ‘make the big leagues’ and become part of the DSM to make sure everyone is aware of it.”