Is Caffeine Withdrawal a Mental Disorder?
1 in 8 People Can't Function Without Daily Fix
Interference, Not Just Symptoms
That's key for inclusion in the DSM, says John Hughes, MD, a University of Vermont psychiatrist and addiction specialist who serves as a medical consultant for the book.
"Caffeine withdrawal was proposed for DSM-IV [the current edition of DSM], but the major objection to including it as a disorder was an absence of good data showing clinical significance," says Hughes, who was not involved in Griffiths' study. "Not only do you have to show it produces symptoms, but you have to show that those symptoms can interfere with daily function."
This study, co-authored by American University researcher Laura Juliano, PhD, does that, says Hughes. "It shows very nicely that the effects of caffeine withdrawal are consistent, that several symptoms are of large magnitude, and that a minority of people cannot perform daily functions when they go without caffeine," he tells WebMD.
Their study shows no difference in withdrawal symptoms based on the source of caffeine, which includes coffee and sodas, some teas, chocolate, and medications such as Excedrin and NoDoz. "Caffeine is caffeine, from a pharmacologic point of view," says Griffiths.
In the U.S., average daily caffeine intake is about 280 milligrams -- what's in two mugs of coffee or three to five cans of soft drinks. Up to 90% of people regularly use caffeine, and about 100 milligrams is enough to trigger withdrawal symptoms, says Griffiths.
Should You Quit?
Still, both experts say just because caffeine withdrawal can produce symptoms doesn't mean it's dangerous.
"I'm hesitant to even call caffeine an 'addiction,' because addiction has to do with the inability to stop or control," says Hughes. "Most people can stop drinking coffee, even if they have symptoms when they do."
Griffiths agrees. "The fact that caffeine produces physical dependence isn't necessarily grounds in and of itself to quit," he says. "But if you want to, the best way is with a gradual withdrawal -- just slowly change the proportion of caffeinated and decaffeinated coffee until you're only drinking decaf. Don't stop abruptly; that will likely cause more symptoms."
The real message of Griffiths' findings: "It's that people should realize the possibility that caffeine withdrawal may be responsible for some symptoms," says Hughes. "If you have recurring headaches or fatigue, you really to think that it may be due to caffeine withdrawal."