Caffeine Withdrawal

Caffeine withdrawal symptoms can be different for everyone and typically last anywhere from two to nine days. For someone who consumes caffeine regularly, even in small amounts, both cognitive and physiological symptoms are common when they reduce consumption. 

Cognitive symptoms

Below are some of the most common cognitive symptoms of caffeine withdrawal: 

• Anxiety
• Depression or sadness 
• Drowsiness
• Difficulty concentrating
• Brain fog
• Agitation or irritability

Physiological symptoms

Below are some of the physical symptoms one might experience when withdrawing from caffeine: 

• Headache
• Fatigue
• Increased heart rate
• Flushed skin
• Abdominal pain, nausea, or gastric issues
• Hand tremors
• Cravings for more caffeine 

Typically, the more coffee a person regularly consumes, the more severe the side effects may be during caffeine withdrawal. However, researchers have noticed withdrawal effects in those who regularly consume small amounts of caffeine (100 mg) per day, or the equivalent of one cup of coffee.

To be diagnosed with caffeine withdrawal, an individual must have recently significantly cut back or eliminated caffeine in their diet, and symptoms must be attributed to this syndrome by ruling out any other medical or mental health conditions such as migraines, meningitis, encephalitis, carbon monoxide poisoning, panic attacks,³ and other clinically significant conditions. 

The cause of caffeine withdrawal is an individual significantly cutting back or cutting out caffeine after consuming it regularly. Reactions can vary depending on the biology of the person. Caffeine blocks adenosine receptors in the central nervous system. The chemical adenosine promotes feelings of tiredness, so when its receptors are blocked, we feel more alert and energized. This blockage can also help facilitate the functioning of dopamine and adrenaline, which further stimulate the nervous system. 

Following repeated caffeine use, the brain responds by increasing the number of adenosine receptors in the central nervous system, meaning larger quantities of caffeine are required to produce similar effects. Additionally, caffeine can cause blood vessels to constrict, slowing down blood flow in the brain. Suddenly reducing caffeine consumption can cause the blood vessels to expand again. The resultant increase in blood flow helps explain why people who quit cold turkey often experience headaches, difficulty concentrating, and other symptoms of caffeine withdrawal.

Caffeine is not necessarily good or bad, and people may consume it safely. However, some groups may be more vulnerable to the adverse effects of caffeine and may wish to limit their intake, including but not limited to:  

• People who are pregnant or breastfeeding
• Children
• Those with IBS or other gastrointestinal issues
• Individuals with certain chronic health conditions such as insomnia, anxiety, chronic migraines, or cardiac issues

The treatment for caffeine withdrawal is most commonly education on appropriate reduction of caffeine intake. Below are other treatment options.

Other treatments 

The healthiest way to cut back on caffeine consumption and avoid withdrawal symptoms may be techniques that involve gradual reduction. The first step of reduction can be understanding how much caffeine is present in what is consumed. For example, an eight-ounce cup of coffee will typically have around 80-100 mg of caffeine, while an eight-ounce energy drink may have up to 250 mg. While coffee and energy drinks are common culprits, there can be hidden amounts of caffeine in several dietary supplements, over-the-counter medications, snacks, soft drinks, and tea products. 

Strive to cut back caffeine intake by 10% each week to avoid the most unpleasant symptoms of caffeine withdrawal. Some strategies may include:  

• Replacing regular coffee with decaf—When drinking a lot of coffee throughout the day, one can start replacing alternating cups with decaf or start cutting the regular coffee with decaf, making half-caf servings
• Replace soft drinks with fruit-infused water or flavored seltzer water
• Avoid diet supplements 
• Switch to herbal teas
• Check labels for caffeine content to get familiar with amounts in common food and drink
• Take an over-the-counter (OTC) pain reliever for headaches caused by withdrawal
• Aim to get seven to nine hours of quality sleep every night 
• Avoid consuming any caffeine past noon, as doing so may interfere with sleep patterns

Cognitive-behavioral therapy (CBT) can be an effective way to learn new habits by changing old behavior patterns and replacing them with new ones. Licensed therapists can support the desire to cut back or cut out caffeine for those who believe their consumption has a detrimental effect on their lives. They can offer coping mechanisms and stress management strategies and help clients identify and change old negative thought patterns into more positive ones. They can also connect offer relevant resources, such as medically reviewed articles on caffeine withdrawal. 

Online therapy is an option that offers various choices to individuals who may not otherwise be able to find therapy due to geographical location or inability to travel to in-person sessions. Online therapy platforms like BetterHelp use a targeted questionnaire to match users with licensed therapists to meet their specific needs. Therapy sessions are conducted via video conferencing, chat, or phone. 

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

In a 2017 comprehensive review, researchers suggest that caffeine consumption is relatively safe at levels that are presented in commercially available food and beverages. However, specific populations may be more vulnerable to the adverse effects of caffeine, including children, people who are pregnant or lactating, or those who experience mental illness. They also report that excess caffeine consumption can be harmful and recommend further study into emerging concerns about over-consumption. 

A review of evidence conducted in 2014 concluded that recent research on caffeine showed that not all consumers were aware of the effects of caffeine dependency and withdrawal and attributed signs like headache, fatigue, nausea, and other symptoms to illness.  

90% of people in the US drink caffeine regularly

90% of people in the US consume caffeine regularly, at an average of over 200mg per day. Those who drink amounts over 500mg may experience impacts of caffeine withdrawal, but symptoms can be noted in anyone who frequently uses caffeine and ceases use quickly.¹

¹National Library of Medicine

Below are more key statistics on caffeine withdrawal:

• In a survey of addiction professionals from 2013, researchers found that 95% of these professionals believed that cessation of caffeine would cause a withdrawal syndrome, and 73% thought that this caffeine withdrawal could have clinical significance. 
• In the same survey, 58% of these professionals stated they believed some people develop a dependence on caffeine, although only 44% believed that dependence should be added to the DSM.
• The outcomes for those who seek advice, diagnosis, and 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.