Caffeine withdrawal

See also: Caffeine dependence

Caffeine withdrawal is a set of symptoms, behaviors, and physiological changes that can occur when an individual significantly reduces or stops consuming caffeine. This condition typically arises in individuals who have regularly consumed caffeine over an extended period or in substantial amounts. Common sources of caffeine include coffee, energy drinks, and certain over-the-counter medications.

Caffeine withdrawal
Molecular structure of caffeine
Specialty	Psychiatry
Symptoms	Headache, fatigue or drowsiness, depression, irritability, difficulty concentrating, nausea or vomiting[1][2]
Usual onset	12–48 hours after the last use[2]
Duration	Up to 7 days[2]

Signs and symptoms

Caffeine withdrawal can present with a variety of symptoms, which may range from mild to severe. Common symptoms include:^[3][2][1]

• Headache
• Irritability
• Depressed or low mood
• Fatigue or drowsiness
• Nausea or vomiting
• Difficulty concentrating

In some cases, withdrawal symptoms can cause significant distress or impair daily activities. While rare, extreme cases may be temporarily incapacitating.^[4]

Causes

Prolonged caffeine use leads to physical dependence.^[3] When caffeine intake is suddenly reduced or halted, the body may respond with withdrawal symptoms. For habitual users, caffeine's reinforcing effects are often linked to its ability to suppress mild withdrawal symptoms that emerge after short periods without caffeine, such as overnight abstinence. This cyclical pattern may contribute to ongoing caffeine consumption.^[5]

Diagnosis

Caffeine withdrawal is recognised as a clinical diagnosis in major diagnostic manuals, including the DSM-5-TR, ICD-10, and ICD-11.^[5] Diagnosis is based on the presence of characteristic symptoms following a reduction in caffeine intake.

Differential diagnosis

The symptoms of caffeine withdrawal can resemble those of other medical and neurological conditions. Common conditions that may be mistaken for caffeine withdrawal include migraine and other headache disorders, tension, viral infections, sinus conditions, medication side effects, and other drug withdrawal syndromes.^[1]

Comorbidity

Caffeine withdrawal is sometimes associated with other mental disorders. Conditions that may co-occur with caffeine withdrawal include generalized anxiety disorder, antisocial personality disorder, major depressive disorder, panic disorder, alcohol use disorder (moderate to severe), and cocaine and cannabis use.^[1]

Management

For those experiencing caffeine withdrawal, headaches may respond to common pain relievers such as aspirin or other analgesics.^[5] If withdrawal occurs as part of a planned reduction in caffeine intake, gradually tapering consumption is generally recommended to minimize symptom severity.^[5]