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The mysterious link between caffeine and psychosis: Why does it trigger hallucinations?
Caffeine-induced psychosis is a relatively rare phenomenon that may occur in otherwise healthy people. Excessive caffeine intake may worsen psychotic symptoms in people with schizophrenia. This phenomenon often manifests itself as psychotic symptoms such as delusions, paranoia, and hallucinations. Still, actual evidence is limited, either from high doses of caffeine or from chronic caffeine abuse.
Understanding mental illness
Psychosis refers to a group of symptoms that affect thinking, with a partial loss of contact with reality. During a psychotic episode, an individual's thinking and perception are disrupted, and it may be difficult to distinguish between reality and unreality. This state of mind can arise from a variety of mental illnesses (eg, schizophrenia, bipolar disorder), physical illnesses (eg, Parkinson's disease, Alzheimer's disease), or certain substances (eg, stimulant drugs).
Caffeine use and its risks
Approximately 85% of the U.S. population consumes caffeine in some form every day. The most common ways of ingesting it are through freshly brewed coffee, instant coffee, tea, soda and chocolate.
For example, a 6-ounce serving of freshly brewed coffee contains about 100 mg of caffeine, while instant coffee contains about 65 mg, tea has about 40 mg, soda has about 35 mg, and chocolate has about 5 mg. The majority of the population consumes approximately 210 milligrams of caffeine daily, and some people with a high tolerance to caffeine consume more than 500 milligrams of caffeine daily.
It is worth noting that about 80% of people with schizophrenia smoke daily, and smoking consumes most of the caffeine they consume, so they often need to consume more caffeine than others to maintain caffeine levels . Many people with schizophrenia use caffeine to combat boredom or to counteract the sedative effects of antipsychotic medications. Furthermore, people with schizophrenia may develop polydipsia, which means they feel excessively thirsty despite taking in enough fluids.
The effects and treatment of caffeine
Caffeine use may cause restlessness, nervousness, insomnia, chattering, and agitation and may worsen the symptoms of schizophrenia.
Caffeine is metabolized in the body by the CYP1A2 enzyme, and competitive inhibition of this enzyme affects a variety of psychotropic drugs. Therefore, caffeine interacts with different medications and may complicate symptoms and medication side effects in patients with psychosis.
To reduce side effects, people with schizophrenia should reduce their caffeine intake. Research shows that consuming less than 250 milligrams of caffeine per day can lead to better performance on cognitive tasks in people with schizophrenia. However, further research is needed to confirm the relevance of this moderate caffeine intake to the general population.
Treatment and Prevention
Recent reports mentioned that a 47-year-old patient developed chronic caffeine-induced psychosis due to high caffeine intake. After reducing caffeine intake, the patient returned to normal within seven weeks without the use of antipsychotic drugs. For schizophrenia patients with caffeine addiction, the best treatment is to gradually reduce caffeine intake and avoid abrupt discontinuation, which can worsen the side effects of psychotic or mood disorders. For caffeine overdose patients who do not suffer from psychosis, doctors may prescribe antipsychotic drugs to prevent the effects of psychosis; while for patients with psychosis, they should still slowly control their caffeine intake and continue to take antipsychotic drugs.
So, are there more mental health risks lurking behind this seemingly harmless caffeine that we don’t yet understand?
