If you notice that you often feel nervous or jittery, it might be a good idea to look at your caffeine intake and cut it back. For reference, a large (“grande”) coffee at Starbucks contains about 330 mg of caffeine. Nevertheless, these results are preliminary.Ĭoffee’s caffeine content is highly variable. Interestingly, stress levels were similar between regular and less frequent caffeine consumers, suggesting the compound may have the same effect on stress levels regardless of whether you drink it habitually ( 12). One study in 25 healthy men found that those who ingested approximately 300 mg of caffeine experienced more than double the stress of those who took a placebo. In fact, caffeine-induced anxiety disorder is one of four caffeine-related syndromes listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association.Įxtremely high daily intakes of 1,000 mg or more per day have been reported to cause nervousness, jitteriness and similar symptoms in most people, whereas even a moderate intake may lead to similar effects in caffeine-sensitive individuals ( 9, 10).Īdditionally, modest doses have been shown to cause rapid breathing and increase stress levels when consumed in one sitting ( 11, 12). However, at higher doses, these effects may become more pronounced, leading to anxiety and nervousness. At the same time, it triggers the release of adrenaline, the “fight-or-flight” hormone associated with increased energy ( 8). Imminent cardiac arrest in caffeine toxicity should prompt intra-lipid therapy to scavenge the free serum caffeine.It works by blocking the effects of adenosine, a brain chemical that makes you feel tired. Caffeine exhibits ideal characteristics to be dialyzed, including low protein binding (36%), low molecular size (194), and a small volume of distribution (0.6 to 0.8 L/kg). Hemodialysis has been effective in severe, life-threatening caffeine ingestions. Īctivated charcoal can bind caffeine if the ingestion is recent, and repeated doses can help diminish serum levels via the enterohepatic circulation. Vasopressors, such as vasopressin or phenylephrine, can be used to maintain blood pressure (goal mean arterial pressure greater than 65 mm Hg) without worsening tachycardia. Procainamide, lidocaine, or bicarbonate have also been utilized for the treatment of tachydysrhythmias. Beta-blockade with esmolol is useful for tachycardia. Hydration may be oral in minor cases, yet severe cases benefit from intravenous (IV) hydration. The primary treatment for minor caffeine ingestion is supportive. įatal caffeine overdose is relatively uncommon, and treatment data is limited to case reports. Cardiac monitoring allows evaluation of heart rate and early recognition of dysrhythmias such as ventricular ectopy or fibrillation. An electrocardiogram may demonstrate tachycardia, ST-segment depressions, or T-wave inversions. It is also important to obtain serum myoglobin and creatine kinase levels to monitor for rhabdomyolysis. Caffeine toxicity can result in hypokalemia, hypocalcemia, hyponatremia, and hyperglycemia. Ī venous blood gas may demonstrate anion gap metabolic acidosis, which can be severe. Lethal blood levels are typically above 80 to 100 mg/L, although one case occurred at 15 mg/L. Although not available in all hospitals, serum caffeine levels are generally obtained with an immunoassay. Serum caffeine levels can guide prognosis and therapy. Routine serum laboratory evaluations can be useful in drug overdose cases, especially in the setting of unstable vital signs, seizures, or altered sensorium.
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