If you think about it, caffeine is the most commonly used psychoactive substance. Like most people, I enjoy my coffee and tea, but in moderation. On the other hand, as discussed below, persons with certain mental health problems should be given specific advice about their caffeine intake.
What should we do?
Ask
1. The substance use history should also include the amount of caffeine consumed per day.
2. In particular, we should ask whether the person uses any so-called “energy” drinks. This is especially important in young people.
Educate
1. We should know and educate our patients about which products have how much caffeine.
2. Our patients often avoid caffeine in the evening. But we should educate them that the half-life of caffeine in adults varies from 3 to 7 hours. Caffeine’s prominent effect lasts approximately 3 to 4 hours, but this duration can vary from person to person. Also, note that about 10 hours later, 25% of the caffeine taken is still in the bloodstream.
Advise
1. Insomnia
Avoid caffeine for at least 10 hours (yes, at least 10 hours!) prior to bedtime.
2. Anxiety
People with anxiety are very sensitive to the effects of caffeine. They should taper down their caffeine intake, ideally to zero.
3. ADHD
Persons with ADHD often consume large amounts of caffeine, but once on a stimulant medication, they should taper down the caffeine intake. They don’t need it because the stimulant medication is much more powerful than caffeine. Stimulant medications plus high doses of caffeine often lead to worsening anxiety, palpitations, and even supraventricular arrhythmias.
4. Bipolar disorders
Minimize caffeine intake because it is known to precipitate manic or hypomanic episodes in some patients.
5. On clozapine
Caffeine inhibits cytochrome P450 1A2, the primary enzyme that metabolizes clozapine. So, a significant increase in caffeine intake can increase the clozapine level, and a significant decrease in caffeine intake can decrease the clozapine level.
Next, please see the other articles on this website related to caffeine and its effect on mental health and psychiatric medications under Related Pages below.
Related Pages
How much caffeine is too much?
Key things clinicians should know about caffeine withdrawal
Minimizing caffeine may be helpful in bipolar disorder
Caffeine can significantly change serum clozapine levels
Interactions that can significantly affect caffeine metabolism
Should those with migraine not consume caffeine?
Caffeine content of coffee and tea
Should we recommend decaffeinated coffee?
Caffeine content of soft drinks
Caffeine content of “energy” drinks
References
Consumerreports.org
http://www.consumerreports.org/cro/2012/04/caffeine-levels-in-drinks-snacks-and-drugs/index.htm
Harland BF. Caffeine and nutrition. Nutrition. 2000 Jul-Aug;16(7-8):522-6. PubMed PMID: 10906543.
Health Canada. http://www.hc-sc.gc.ca/fn-an/securit/addit/caf/food-caf-aliments-eng.php
Starbucks.com. https://news.starbucks.com/uploads/documents/nutrition.pdf
Thakre TP, Deoras K, Griffin C, Vemana A, Podmore P, Krishna J. Caffeine Awareness in Children: Insights from a Pilot Study. J Clin Sleep Med. 2015 Jul 15;11(7):741-6. PubMed PMID: 25845895
Copyright © 2016 to 2025, Simple and Practical Medical Education, LLC. All rights reserved. The content on this website may not be reproduced in any form without express written permission.
Disclaimer: The material on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified healthcare professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.
Leave a Reply