Paranoia espresso

[David Baxter PhD]

Paranoia espresso
Mind Hacks Blog
May 07, 2009

A case study just out in CNS Spectrums describes an apparent case of caffeine-induced psychosis. The summary is below although the full paper is available online as a pdf.

If you're a regular coffee drinker, I don't think you should worry though. It's impossible to say whether caffeine was the definite cause in this case, and the gentleman concerned was drinking about 36 cups of coffee a day.

Caffeine-induced psychosis
Hedges DW, Woon FL, and Hoopes SP.

As a competitive adenosine antagonist, caffeine affects dopamine transmission and has been reported to worsen psychosis in people with schizophrenia and to cause psychosis in otherwise healthy people. We report of case of apparent chronic caffeine-induced psychosis characterized by delusions and paranoia in a 47-year-old man with high caffeine intake. The psychosis resolved within 7 weeks after lowering caffeine intake without use of antipsychotic medication. Clinicians might consider the possibility of caffeinism when evaluating chronic psychosis.​

 

[ladylore]

For a moment there I thought I was in trouble and that it explained alot.

On my bad days I can drink up to about 6 cups of coffee. I do try to keep to 3 a day.:whew:

 

[Halo]

36 cups of coffee a day.

Holy crap....what kind of bladder did the guy have

I thought I was bad with caffeine but that is absurd.

 

[NicNak]

The first thing I thought of when I read that artical is overhydration it doesn't specify (unless I missed it) if this particular person had any other beverages through out the day. Also depending on the size of the coffees that still seems, to me, like a lot of fluids.

Although the artical I posted below speaks of water. I would think coffee would just amplify the effects that an overhydration of water would do...

Just a observation I had

I remember my Psychiatrist always telling me in the summer, to be extra careful about keeping cool and hydrated, but not to overhydrate as well.

Overhydration
The Merck Manual Online Medical Library

Overhydration is an excess of water in the body.

People can have overhydration if they drink too much or if they have a disorder that decreases the body's ability to excrete water. Often, no symptoms occur, but people may become confused or have seizures. Fluid intake is restricted and diuretics may be given.

Overhydration occurs when the body takes in more water than it loses. Overhydration can occur, for example, when athletes drink excessive amounts of water or sports drinks to avoid dehydration, or when people drink much more water than their body needs because of a psychiatric disorder called psychogenic polydipsia. The result is too much water and not enough sodium. Thus, overhydration generally results in low sodium levels in the blood, which can be dangerous. However, drinking large amounts of water usually does not cause overhydration if the pituitary gland, kidneys, liver, and heart are functioning normally. To exceed the body's ability to excrete water, a young adult with normal kidney function would have to drink more than 6 gallons of water a day on a regular basis.

Overhydration is much more common among people whose kidneys do not excrete urine normally—for example, among people with a disorder of the heart, kidneys, or liver. Overhydration may also result from the inappropriate secretion of antidiuretic hormone. In this syndrome, the pituitary gland secretes too much antidiuretic hormone, stimulating the kidneys to conserve water when that is not needed. Premature infants may become overhydrated if they receive too large an amount of intravenous fluids.

Brain cells are particularly susceptible to overhydration and to low sodium levels in the blood. When overhydration occurs slowly, brain cells have time to adapt, so few symptoms occur. When overhydration occurs quickly, confusion, seizures, or coma may develop.

Doctors try to distinguish between overhydration and excess blood volume. With overhydration and normal blood volume, the excess water usually moves into the cells, and tissue swelling (edema) does not occur. With overhydration and excess blood volume, an excess amount of sodium prevents the excess water from moving into the cells. Instead, the excess water accumulates around the cells, resulting in edema in the chest, abdomen, and lower legs.

Treatment
Regardless of the cause of overhydration, fluid intake usually must be restricted (but only as advised by doctors). Drinking less than a quart of fluids a day usually results in improvement over several days. If overhydration occurs because of heart, liver, or kidney disease, restricting the intake of sodium (sodium causes the body to retain water) is also helpful.

Sometimes, doctors prescribe a drug to increase sodium and water excretion in the urine (diuretic). In general, diuretics are more useful when overhydration is accompanied by excess blood volume.

 

[David Baxter PhD]

But excessive caffeine intake can also lead to dehydration and increased blood pressure...

 

[NicNak]

This has my wheels turning. I keep trying to think of all the possable contributing factors and how all of them could result in a psychosis episode.

I for sure believe it could. Just in my mind, trying to figure out how, why and how it all folds in together.

I always wanted to be a doctor :blush: so these types of articals really get my brain running.

 

[ladylore]

But excessive caffeine intake can also lead to dehydration and increased blood pressure...

And anxiety.

 

[David Baxter PhD]

And anxiety.

Oh, yeah...

 

[NicNak]

But excessive caffeine intake can also lead to dehydration and increased blood pressure...

And anxiety.

Once he lowered his coffee intake, he was able to decrease his meds for hypertension too but then 7 years afterwards developed anxiety and depression.

It makes me wonder if the prolonged exposure to the caffeine could have had long term effects on the dopamine receptors, causing the depression and anxiety to later surface.

I am wondering too, if the psychosis wasn't caught as quickly as it was, if that too could have resulted in this fellow having long term psychosis.

And if the dehydration, or even the amount of sugar possably he was consuming. ( :yikes3: Imagine how much in a gallon of coffee ) could have also had long term effects.

 

[ladylore]

Poor guy must have been literally bouncing off the walls. I can't imagine drinking 36 cups of coffee a day. Wow.

 

[Halo]

Once in my life my friend and I had a coffee drinking contest to see who could drink more and I gave up after 22 cups...it was brutal. I had gut rot, couldn't sleep and my anxiety (which I didn't realize I had that many years back) was going haywire.

Trust me, I never tried that again

 

[Budoaiki]

I like the odd cup of coffee, I prefer tea but I don't like either that much.
36 cups a day, I mean wow. I wonder if he had any ulcers, after that much caffeine his stomach must have been in pretty ruff shape. I wonder how healthy his renal system and the rest of his body is, then again the human body is a miraculous thing in it's adaptability. Still I wonder how his body is at balancing electrolytes after all that also I bet his energy level would fluctuate without the regular caffeine intake affecting his ATP and ADP levels. Very interesting study and a reminder of the importance of moderation.