Abrupt cessation of caffeine often results in several withdrawal symptoms among habitual caffeine consumers.
The objective of the study was to determine whether caffeine withdrawal symptoms co-exist as clusters in some individuals.
Materials and methods
Withdrawal symptoms and caffeine intake were assessed for men (n = 126) and women (n = 369), aged 20–29, using a caffeine habits questionnaire and a semi-quantitative food frequency questionnaire, respectively. Principal components factor analysis was used to identify common underlying factors among 14 well-described caffeine withdrawal symptoms. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to determine if the likelihood of reporting a withdrawal factor was associated with habitual caffeine consumption.
The 14 withdrawal symptoms were grouped into three factors termed “fatigue and headache”, “dysphoric mood”, and “flu-like somatic”. The likelihood of reporting the fatigue and headache and dysphoric mood factors increased with higher levels of habitual caffeine consumption. Compared to <100 mg/day of caffeine, the ORs (95% CI) of reporting the fatigue and headache factor with a habitual intake of 100–200 mg/day and >200 mg/day were 1.97 (1.21, 3.21) and 4.44 (2.50, 7.86), respectively. The corresponding ORs (95% CI) for the dysphoric mood factor were 1.55 (0.96, 2.52) and 3.34 (1.99, 5.60).
The 14 well-described caffeine withdrawal symptoms factor into three clusters, suggesting the existence of three distinct underlying mechanisms of caffeine withdrawal. Increasing habitual caffeine consumption is associated with an increased likelihood of reporting the fatigue and headache and dysphoric mood symptoms, but not the flu-like somatic symptoms.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR, 4th edn. American Psychiatric Association, USA
Barone JJ, Roberts HR (1996) Caffeine consumption. Food Chem Toxicol 34:119–129
Cornelis MC, El-Sohemy A (2007) Coffee, caffeine, and coronary heart disease. Curr Opin Lipidol 18:13–19
Dews PB, Curtis GL, Hanford KJ, O’Brien CP (1999) The frequency of caffeine withdrawal in a population-based survey and in a controlled, blinded pilot experiment. J Clin Pharmacol 39:1221–1232
Evans SM, Griffiths RR (1999) Caffeine withdrawal: a parametric analysis of caffeine dosing conditions. J Pharmacol Exp Ther 289:285–294
Evans SM, Critchfield TS, Griffiths RR (1994) Caffeine reinforcement demonstrated in a majority of moderate caffeine users. Behav Pharmacol 5:231–238
Fredholm BB, Battig K, Holmen J, Nehlig A, Zvartau EE (1999) Actions of caffeine in the brain with special reference to factors that contribute to its widespread use. Pharmacol Rev 51:83–133
Goldstein A (1964) Wakefulness caused by caffeine. Naunyn Schmiedebergs Arch Exp Pathol Pharmakol 248:269–278
Goldstein A, Kaizer S (1969) Psychotropic effects of caffeine in man. 3. A questionnaire survey of coffee drinking and its effects in a group of housewives. Clin Pharmacol Ther 10:477–488
Griffiths RR, Mumford GK (1996) Caffeine reinforcement, discrimination, tolerance and physical dependence in laboratory animals and humans. In: Balster RL, Kuhar MJ, Schuster CR (eds) Pharmacological aspects of drug dependence: toward an integrated neurobehavioral approach (Handbook of experimental pharmacology, v. 118). Springer, Berlin
Griffiths RR, Woodson PP (1988) Caffeine physical dependence: a review of human and laboratory animal studies. Psychopharmacology (Berl) 94:437–451
Griffiths RR, Bigelow GE, Liebson IA (1986) Human coffee drinking: reinforcing and physical dependence producing effects of caffeine. J Pharmacol Exp Ther 239:416–425
Griffiths RR, Evans SM, Heishman SJ, Preston KL, Sannerud CA, Wolf B, Woodson PP (1990) Low-dose caffeine physical dependence in humans. J Pharmacol Exp Ther 255:1123–1132
Hofer I, Battig K (1994) Cardiovascular, behavioral, and subjective effects of caffeine under field conditions. Pharmacol Biochem Behav 48:899–908
Hughes JR, Oliveto AH (1997) A systematic survey of caffeine intake in Vermont. Exp Clin Psychopharmacol 5:393–398
Hughes JR, Higgins ST, Bickel WK, Hunt WK, Fenwick JW, Gulliver SB, Mireault GC (1991) Caffeine self-administration, withdrawal, and adverse effects among coffee drinkers. Arch Gen Psychiatry 48:611–617
Hughes JR, Oliveto AH, Bickel WK, Higgins ST, Badger GJ (1993) Caffeine self-administration and withdrawal: incidence, individual differences and interrelationships. Drug Alcohol Depend 32:239–246
Hughes JR, Oliveto AH, Liguori A, Carpenter J, Howard T (1998) Endorsement of DSM-IV dependence criteria among caffeine users. Drug Alcohol Depend 52:99–107
Jones HE, Herning RI, Cadet JL, Griffiths RR (2000) Caffeine withdrawal increases cerebral blood flow velocity and alters quantitative electroencephalography (EEG) activity. Psychopharmacology (Berl) 147:371–377
Juliano LM, Griffiths RR (2004) A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology 176:1–29
Kabagambe EK, Baylin A, Allan DA, Siles X, Spiegelman D, Campos H (2001) Application of the method of triads to evaluate the performance of food frequency questionnaires and biomarkers as indicators of long-term dietary intake. Am J Epidemiol 154:1126–1135
Kaiser HF (1958) The varimax criterion for analytic rotation in factor analysis. Psychometrika 23:187–200
Kim J-o, Mueller CW (1978) Factor analysis: statistical methods and practical issues. Sage Publications, California
Lader M, Cardwell C, Shine P, Scott N (1996) Caffeine withdrawal symptoms and rate of metabolism. J Psychopharmacol 10:110–118
Lane JD (1997) Effects of brief caffeinated-beverage deprivation on mood, symptoms, and psychomotor performance. Pharmacol Biochem Behav 58:203–208
Lane JD, Phillips-Bute BG (1998) Caffeine deprivation affects vigilance performance and mood. Physiol Behav 65:171–175
Rogers PJ (2007) Caffeine, mood and mental performance in everyday life. British Nutrition Foundation 32:84–89
Roller L (1981) Caffeinism: subjective quantitative aspect of withdrawal syndrome. Med J Aust 1:146
Satel S (2006) Is caffeine addictive?—a review of the literature. Am J Drug Alcohol Abuse 32:493–502
Silverman K, Evans SM, Strain EC, Griffiths RR (1992) Withdrawal syndrome after the double-blind cessation of caffeine consumption. N Engl J Med 327:1109–1114
Strain EC, Mumford GK, Silverman K, Griffiths RR (1994) Caffeine dependence syndrome. Evidence from case histories and experimental evaluations. Jama 272:1043–1048
USDA (2007) National Nutrient Database for Standard Reference
Verhoeff FH, Millar JM (1990) Does caffeine contribute to postoperative morbidity. Lancet 336:632
World Health Organization (1992a) ICD-10: international statistical classification of diseases and related health problems, 10th revision. edn. World Health Organization, Geneva
World Health Organization (1992b) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization, Geneva
This work was supported by the Advanced Foods and Materials Network (AFMNet). A. El-Sohemy holds a Canada Research Chair in Nutrigenomics.
Disclosure/conflict of interest
The authors report no conflicts of interest.
About this article
Cite this article
Ozsungur, S., Brenner, D. & El-Sohemy, A. Fourteen well-described caffeine withdrawal symptoms factor into three clusters. Psychopharmacology 201, 541–548 (2009). https://doi.org/10.1007/s00213-008-1329-y