title: Caffeine self-administration, withdrawal, and adverse effects among coffee drinkers.
abstract: Twenty-two coffee drinkers (three to seven cups per day) underwent repeated double-blind trials to test for caffeine self-administration, withdrawal, and adverse effects. Each trial consisted first of a randomized crossover period of 1 day of decaffeinated coffee and 1 day of caffeinated coffee (100 mg) to assess withdrawal and adverse effects of caffeine. Next, subjects were given 2 days of concurrent access to the two coffees. The relative use of the two coffees was used to assess caffeine self-administration. Reliable caffeine self-administration occurred in three of 10 subjects in study 1 and seven of 12 subjects in study 2. Withdrawal symptoms were headaches, drowsiness, and fatigue. The major adverse effect from self-administration was tremulousness. The occurrence of headaches on substitution of decaffeinated coffee prospectively predicted subsequent self-administration of caffeine. These results indicate that some coffee drinkers exhibit signs of a caffeine dependence, ie, they self-administer coffee for the effects of caffeine, have withdrawal symptoms on cessation, and experience adverse effects.
authors.affiliation: Department of Psychiatry, University of Vermont, Burlington 05401.
authors.forename: J R
authors.initials: JR
authors.lastname: Hughes
authors.forename: S T
authors.initials: ST
authors.lastname: Higgins
authors.forename: W K
authors.initials: WK
authors.lastname: Bickel
authors.forename: W K
authors.initials: WK
authors.lastname: Hunt
authors.forename: J W
authors.initials: JW
authors.lastname: Fenwick
authors.forename: S B
authors.initials: SB
authors.lastname: Gulliver
authors.forename: G C
authors.initials: GC
authors.lastname: Mireault
mesh_terms: D000328:Adult; D002110:Caffeine / Q000008:administration & dosage / Q000009:adverse effects*; D003069:Coffee; D004311:Double-Blind Method; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D012651:Self Medication / Q000523:psychology*; D012894:Sleep Stages; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D019966:Substance-Related Disorders / Q000209:etiology / Q000523:psychology; D014202:Tremor / Q000139:chemically induced
chemical_list: D003069:Coffee; D002110:Caffeine