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Addressing Caffeine-induced Psychosis: A Clinical Perspective

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

Addictive Disorders Their Treatment: September 2012 - Volume 11 - Issue 3 - p 146–149
doi: 10.1097/ADT.0b013e31823eb8e2
Original Articles
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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.

*Miller School of Medicine, University of Miami; and

Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL.

The authors declare no conflict of interest.

Reprints: Clara L. Alvarez Villalba, MD, Psychiatry and Behavioral Science Department, University of Miami, 3308A JMH-Mental Health Miami, FL 33136 (e-mail: CAVillalba@med.miami.edu).

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved