Caffeine Intoxication

There are a number of psychological and physiological symptoms you may notice if you are experiencing caffeine intoxication, when a person has dangerously high levels of caffeine in their system, including the symptoms below.

Psychological symptoms of caffeine intoxication

Caffeine intoxication may impact mental health or well-being. Below are a few psychological effects of caffeine intoxication you may notice:

• Nervousness or restlessness
• Panic attacks
• Agitation or irritation
• Rambling thoughts or speech
• Difficulty concentrating
• Agitation
• Confusion
• Hallucinations

Physiological symptoms

Physical symptoms may also accompany caffeine intoxication, including but not necessarily limited to the following side effects:

• Frequent urination or bowel movements
• Flushing in the face
• Muscle twitching
• Gastrointestinal disturbances
• Insomnia 
• Rapid heart rate
• Arrhythmia 
• Breathing trouble
• Palpitations
• Agitation
• Tremor
• Insomnia

To be diagnosed with caffeine intoxication via the criteria of the DSM-V, an individual must have recently consumed an amount of caffeine above 250 mg and, shortly after consumption, five or more of the documented symptoms.

In addition, the symptoms must impair the function of the individual, such as interfering with work or social interactions. Finally, the symptoms should not be better attributed to another medical condition, use of other substances, or another mental health condition.

The overconsumption of caffeine causes caffeine intoxication. However, there is no number on the amount (other than this limit of 250 mg) because the body’s reaction to caffeine can differ depending on the individual. 

Caffeine intoxication has become more prevalent in recent years due to the popularity of energy drinks and the addition of caffeine to dietary supplements. The Food and Drug Administration (FDA) does not regulate supplements, so the amount of caffeine in these supplements may not be known. The FDA warns, however, that just one teaspoon of pure powdered caffeine (an addition to certain supplements) is equivalent to 28 cups of coffee.

Risk factors

There are certain risk factors for caffeine intoxication, including the following:  

• Significant consumption by an individual who does not commonly consume products with caffeine
• The use of oral contraceptives (these can interfere with the body’s process of caffeine elimination)
• Certain medications or supplements that may interact with caffeine

Comorbidity with other conditions

Caffeine intoxication is often seen in individuals living with psychotic disorders, depressive disorders, bipolar disorder, sleep disorders, substance use disorders,² or eating disorders. Those with anxiety disorders may be less affected if they avoid caffeine due to worsening symptoms. 

However, medical professionals often do not consider caffeine to be necessarily positive or negative. Caffeine use in small to moderate doses can help boost energy levels and, over time, can decrease risks for specific medical conditions like Parkinson’s, Alzheimer’s, or stroke. However, every individual can react to caffeine differently. If you are concerned about how your body responds when you consume caffeine, or notice a negative impact on function, you may choose to decrease your intake or cut it out altogether.

Caffeine intoxication is an acute³ condition and, as such, often goes away by itself in a few hours. Rehydrating the body with water can hasten a reduction of symptoms, as can walking or other physical activities. 

Medication

There are no current medications approved to treat caffeine intoxication. However, if you drink or consume a significant amount of caffeine that leads to severe symptoms, it may be beneficial to talk to your primary care provider. If you have symptoms like passing out, shortness of breath, fever, or heart problems, seek care from an urgent care provider. For advice on medication options, consult your doctor. Do not start, stop, or change a medication without consulting with a healthcare professional.

Other treatments

In some extreme cases, overconsumption of caffeine (a dose between five to ten grams) can lead to potentially fatal medical conditions such as respiratory failure or grand mal seizures. In these scenarios, immediate medical intervention may be necessary. If you are concerned that you or someone else has consumed a dangerous amount of caffeine, you can call Poison Control at 1-800-222-1222 to speak with a poison specialist. If the person requires hospitalization due to a caffeine overdose, medical professionals may offer IV fluids, give supplements, or dose with activated charcoal. Activated charcoal can stop absorption by preventing caffeine from entering the gut. 

Self-care

Below are a few self-care methods for cutting back on caffeine: 

• Reduce amounts slowly over time to avoid side effects like headaches or irritability 
• Replace coffee or tea with decaffeinated versions
• Drink herbal tea or fruit-infused water instead of caffeinated soft drinks
• Avoid dietary supplements

Caffeine is not often as harmful as other substances like alcohol or street drugs. However, overuse can still negatively impact one’s quality of life. Therapy can help target underlying issues that may be contributing to a dependence on caffeine and replace this potentially agitating substance with positive coping skills and healthy lifestyle habits. 

Therapy may be more available in the 21st century, with the rising popularity of online therapy. With online therapy platforms like BetterHelp, even people who live in geographical areas that don’t offer many therapy options can be matched with a licensed therapist that meets their needs. Participants meet with their therapist over video conferencing, direct messages, or the phone. 

More resources on caffeine intoxication:

• National Library of Medicine: Caffeine Toxicity
• Federal Food and Drug Administration: Spilling The Beans, How Much Caffeine is Too Much?
• Princeton University Health Services: Caffeine

A comprehensive review completed in 2017 found that caffeine ingestion is relatively safe when taken in the doses found in commercially available food and drink. The most significant risks for caffeine intoxication come from the mixing of caffeine with other substances, for example, energy drinks and alcoholic beverages. Some populations have a greater vulnerability toward harm from caffeine, including pregnant people, children, or individuals with mental health conditions. 

Additional studies surrounding caffeine intoxication

In a literature review from 2014, some medical professionals and researchers suggest that caffeine use disorder⁴ may be added to the next iteration of the DSM due to the rare but existent cases where caffeine demonstrates the ability to interfere with well-being and daily function in individuals. At this time, caffeine intoxication and caffeine withdrawal⁵ are the two conditions that come closest to a diagnosis of a disorder involving this substance. 

In a study by Johns Hopkins in 2019, researchers discovered that the withdrawal symptoms from caffeine occur at a lower dose than previously believed. Participants in the study found that those with an intake of as little as 6 oz of coffee (100 mg of caffeine) were susceptible to withdrawal symptoms like headaches, fatigue, and irritability.

Caffeine overdose is highly unlikely under 400mg of use

Treatment outcomes for individuals experiencing caffeine withdrawal are positive, and studies show it is highly unlikely to overdose on caffeine, especially in amounts under 400mg per day. Powders and supplements may be more dangerous but effects are often medically treatable. ¹

¹Cureus

Below are more critical statistics on caffeine intoxication:

• As the most popular and commonly used drug in the world, studies have found that as many as 85% of Americans consume anywhere from 40 to 150mg of caffeine per day.
• Toxic levels of caffeine consumption can occur quickly, with up to 90% being absorbed in the stomach and reaching peak plasma concentrations within 20 to 40 minutes.
• The outcomes for those who seek treatment for caffeine intoxication are excellent. Overdose of caffeine is extremely rare, and once the symptoms are addressed, there are no residual problems. Less than three dozen deaths from caffeine overdose have been reported in the last ten years.