Caffeine Intoxication

Caffeine intoxication or caffeine overdose occurs by taking excessive psychoactive substance called caffeine which is found in popular drinks like coffee, tea and energy drink. ^[1] 

Epidemiology

The condition is a fairly common toxicological emergency in the U.S. Death however is infrequent. There is no evidence to support race or gender predilection. ^[2]

Causes

According to the American Psychiatric Association DSM-IV, caffeine intoxication is defined as recent caffeine intake typically beyond 250 mg associated with toxicity symptoms. ^[3] Caffeine is found in a lot of beverages including coffee, tea, soft drink, herbal preparations and energy drink. Various pain relieving medications and diet pills also have caffeine. ^[2]

Signs and Symptoms

Patients who suffer from caffeine overdose may experience nausea, vomiting, stomach pain and diarrhea. Since caffeine is a stimulant, affected individuals usually have insomnia or difficulty initiating or maintaining sleep. This can lead to fatigue thus decreased alertness and concentration which can lead to decreased performance. Caffeine is a known diuretic which makes the body liberate more fluid in the form of urine hence the person may feel excessive thirst. Patients also present with increased heart rate, chest discomfort and muscle tremors. Mood changes are common. ^[4]

Diagnosis

History and physical examination are often conclusive especially with mild manifestations. Those who experience moderate and severe symptoms may need laboratory work up. Some of the laboratory exams that may be performed include CBC count, toxin screening, urinalysis and arterial blood gas analysis. Some parameters that need to be checked as well are serum electrolyte, BUN, creatinine, glucose, thyroid levels and total creatine kinase concentration. All females in the childbearing age needs to have a serum pregnancy exam ^[3]

Treatment

Management is often supportive. Airway, breathing and circulation (ABC) are always addressed. Depending on the clinical manifestations, patient may receive activated charcoal, methods to correct irregular heart rhythm, gastric lavage, breathing support and medications such as laxative, anti-hypotension drugs and anti-seizure medicines. ^{[5] [2]}

References:

1. http://www.npjournal.org/article/S1555-4155%2809%2900499-1/abstract
2. http://emedicine.medscape.com/article/821863-overview#a0199
3. http://books.google.com.ph/books?id=HtGb2wNsgn4C&pg=PA409&lpg=PA409&dq=caffeine+intoxication+treatment&source=bl&ots=jmp1lfpXWN&sig=r8LIzgDCyFBSqYfcpXFHtKqCKQA&hl=fil&sa=X&ei=yxyZULeCGIPtrQfskoDIAg&ved=0CFYQ6AEwCDgK#v=onepage&q=caffeine%20intoxication%20treatment&f=false
4. http://www.livestrong.com/article/343162-signs-symptoms-of-caffeine-intoxication/
5. http://www.nlm.nih.gov/medlineplus/ency/article/002579.htm