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Thursday, October 11, 2012
Schizophrenia & Caffeine / Energy and Powerdrinks
Most people consider caffeine to
be a relatively harmless drug. In fact, many people might not even
consider caffeine to be a drug at all. However, caffeine can cause a
host of mental and physical problems when consumed in excess. According
to a review published in 2005 in the journal "Advances in Psychiatric
Treatment," most practitioners don't ask about caffeine intake when
performing psychiatric assessments, despite the fact that caffeine may
exacerbate psychotic and other psychiatric symptoms.
About Schizophrenia
Schizophrenia
is a chronic, debilitating mental health disorder that affects around
2.4 million Americans, according to the 2005 National Comorbidity
Survey-Replication. Symptoms of schizophrenia can range from mild to
severe, involving delusions and hallucinations. People with
schizophrenia generally suffer from thought disorder, meaning that they
have trouble organizing and putting their thoughts into words. They also
tend to exhibit inappropriate, child-like behaviors or extreme
agitation, and often withdraw socially. Schizophrenia also causes
emotional flatness, meaning that patients have little or no interest in
regular activities. People with schizophrenia may neglect personal
hygiene, forgetting to shower or bathe for days or weeks. Sometimes,
schizophrenia can result in symptoms of depression or mood swings.
Because it is a chronic, incurable disease, patients must rely on
medication for symptom relief and management. However, many patients do
not want to take medication because of their serious, although rare,
side effects. Psychotherapy and social interventions may also be
beneficial for schizophrenics.
Effects of Caffeine
For
most people, a moderate intake of caffeine is generally considered
safe. According to Teen's Health, this means an intake of around 200 to
300 mg of caffeine daily. An average cup of coffee contains around 115
mg of caffeine. In moderate amounts, caffeine may help alleviate mental
fatigue and provide a brief energy boost. Ingesting too much caffeine
can lead to a condition known as caffeinism. The authors of the review
from the journal "Advances in Psychiatric Treatment" point out that
caffeinism can lead to symptoms of restlessness, agitation, excitement,
rambling thought and speech, and insomnia, many symptoms that are
consistent with those of schizophrenia and other psychiatric disorders.
This does not imply that caffeine causes schizophrenia but merely
suggests that ingesting too much caffeine may trigger or worsen certain
symptoms.
Clinical Evidence
Several
clinical studies have shown that increased caffeine consumption can
exacerbate schizophrenic symptoms. A case study published in the
September 1978 issue of the "Journal of Clinical Psychiatry" showed that
increased caffeine consumption caused a significant increase in
schizophrenic symptoms. Another study, published in the July 1990 issue
of the journal "Biological Psychiatry" confirmed that, when compared
with a placebo, caffeine caused a significant increase in manic
symptoms, thought disorder, unusual thought content and
euphoria-activation in schizophrenic patients. Additionally, a study
published in the September 2006 issue of "Schizophrenia Research"
confirmed that people with schizophrenia smoke more and have a higher
intake of caffeine when compared with the general U.S. population.
Considerations
While
caffeine may increase schizophrenic symptoms, it is interesting to note
the high number of schizophrenics who rely heavily on caffeine. A
review published in the November 1998 issue of "Psychiatric Services," a
journal of the American Psychiatric Association, suggests that
schizophrenic patients may use high levels of caffeine in an attempt to
self-medicate or alleviate boredom. The authors also state that patients
may use caffeine to combat the sedative effects of certain medications.
Additionally, they point out that many schizophrenics smoke. As smoking
causes an increased elimination of caffeine, schizophrenics may require
increasingly higher amounts of caffeine to achieve the same effects.
The authors of the study published in "Schizophrenia Research" suggest
that clinicians should employ lifestyle modification counseling in
addition to other treatment modalities when working with patients with
schizophrenia to address smoking and caffeine intake.
References
- NIH Fact Sheets: Schizophrenia
- Teen's Health: Caffeine
- "Advances in Psychiatric Treatment"; Neuropsychiatric Effects of Caffeine; A. Winston et al.; 2005
- "Journal of Clinical Psychiatry": Caffeine and Schizophrenia; E. Mikkelsen; 1978
- "Biological Psychiatry"; Effects of the Acute Administration of Caffeine..."; P. LUcas; July 1990
- "Psychiatric Services"; Alcohol & Drug Abuse: Caffeine and Schizophrenia; J. Hughes et al.; November 1998
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