Caffeine is a Drug 2023
The definition of a drug is “a medicine or other substance which has a physiological effect when ingested or otherwise introduced into the body.”
Considering the symptoms of using caffeine, then caffeine is a drug. It would be nice to know why this is so.
This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, Migraine textbook author, podcaster, YouTube video producer, and blogger.
Read my Mini Book on Migraine Here.
What’s not up, doc?
Caffeine is an addictive psychoactive drug which stimulates the sympathetic nervous system like adrenalin does. As a general rule, caffeine in coffee is the most commonly used drug in the world.
Caffeine produces symptoms in humans of rapid heartbeat, increased ability to focus, increased physical ability, and insomnia.
Caffeine is a mildly effective drug for treating Migraine.
Related questions.
Who says that caffeine is an addictive drug?
The DSM V, which is the current edition of the Diagnostic and Statistical Manual for Psychiatric Diagnosis includes in the list of addictive drugs—Caffeine, in amounts as small as 120 mg/day.
Can caffeine produce withdrawal symptoms?
Criteria for caffeine withdrawal:
Prolonged daily use of caffeine followed by:
abrupt cessation or reduction of total caffeine use
closely followed by headache and one or more of the following symptoms.
fatigue/drowsiness
anxiety and/or depression
nausea and/or vomiting
clinically significant distress or impairment in social, occupational, or other important areas of functioning.
What is caffeine intoxication? The diagnostic criteria for caffeine intoxication are recent consumption of caffeine in excess of 250 mg a day and the development of five or more the following signs during, or shortly after caffeine use:
restlessness
nervousness
excitement
insomnia
flushed face
diuresis
gastrointestinal disturbance
muscle twitching
rambling flow of thought and speech
tachycardia or cardiac arrhythmia
periods of inexhaustibility, or psychomotor agitation.
Let’s party!
Approximate amounts of caffeine in various beverages:
Coffee, grande 16 oz Starbucks 550
Coffee, tall 12 oz Starbucks 375
Coffee, short 8 oz Starbucks 250
Redline RTD 250
NoDoz, max strength or Vivarin 200
Monster energy drink 16 oz 160
7-Eleven Big Gulp cola 64 oz 190
Coffee non-gourmet 8 oz 135
Excedrin 2 tabs 130
Coffee instant 8 oz 95
Jolt 711
Anacin 65
Cola 12 oz 35
Mt. Dew 55
Dr. Pepper 39
Pepsi 37
Tab 46
Cappuccino, 8 or 12 oz 35
Expresso Starbucks 1 oz 35
Tea, green or instant 8 oz 30
Chocolate dark, semisweet 1 oz 20
Coffee decaf Starbucks 8 or 12 oz 10
Coffee decaf non-gourmet 8 oz 5
Hot chocolate or cocoa 8 oz 5
Chocolate milk 1 oz 5
Liquid Speed (amount concealed within a proprietary formula)
Caffeinated water ?
John Pemberton invented Coca cola
What are the pharmacological effects of caffeine? Pharmacologically, caffeine acts as a central nervous system stimulator, a point that is well made by the coffee ad on TV which calls it “the think drink.” The duration of the effect of the drug is 6-8 hours, but even one drink in the morning will interrupt sleep in some persons.
Caffeine also acts as a constrictor of smooth muscle, which is found in arteries, the bladder, and the colon. It is the arterial vasoconstrictive action which helps with mild Migraine (Excedrin, B.C. Powder, and Vivactin) and may lead to the rebound or medication overuse headache if one takes too much caffeine (greater than 120 mg 15 days a week) or to caffeine withdrawal symptoms if someone quickly stops their use of caffeine.
Coca Cola which has 35 mg of caffeine was marketed in the United States after the Civil War as an over the counter treatment for Migraine.
The smooth muscle effect also acts as a mild stimulant on the bladder, promoting urination and in the colon, a bowel movement.
Does caffeine help Migraine attacks?
Caffeine as found in coffee, tea, and pop drinks along with Excedrin, B.C. provides mild treatment for Migraine headache.
Can caffeine cause chronic migraine or medication overuse headache? The International Classification of Headache states using caffeine 15 days a month can cause daily headaches in some patients, called chronic migraine, due to medication overuse headache.
The American Migraine Society has stated that caffeine is the number 1 over the counter drug causing medication overuse headache.
What other medical problems can caffeine use aggravate?
GERD-gastroesophageal reflux disorder (heartburn)
Generalized anxiety disorder
Panic disorder
Insomnia
Epilepsy
Death (rarely)
Migraine/medication overuse headache
I urge all caffeine addicted patients, migraine patients, Panic Disorder patients, and patients with sleep disorders to taper off caffeine (which, as I said above, is a drug).
Summary:
Caffeine is the most commonly used over the counter addictive drug. Too much of it can aggravate Migraine producing medication overuse syndrome and suddenly stopping it may cause caffeine withdrawal symptoms.
Check out my Big Book on Migraine Here.
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All the best.
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Britt Talley Daniel MD
