Caffeine withdrawal


  • Caffeine dependence and withdrawal is very common
  • Up to 52% of moderate caffeine uses have withdrawal symptoms[1]

Common Dosages by Type

Type Amount Caffeine^
Coffee, brewed 1 cup 100mg
Coffee, instant 1 cup 75mg
Tea 1 cup 50mg
Red Bull 1 can 80mg
Rockstar 1 can 160mg
Excedrin Migraine 2 tabs 130mg

^Average caffeine content can vary[2][3]

Clinical Features

  • Most common symptoms
    • Headache
    • Fatigue
    • Decreased energy/activeness
    • Decreased alertness
    • Drowsiness
    • Decreased contentedness
    • Depressed mood
    • Difficulty concentrating, irritability, and foggy/not clearheaded
  • Additional symptoms
    • Flu-like symptoms
    • Nausea/vomiting
    • Muscle pain/stiffness

Differential Diagnosis






Aseptic Meningitis


  • History should can be sufficient
  • Consider further workup in ambiguous cases


  • OTC analgesics
  • Hydration
  • Rest/Sleep


  • Rule out more serious etiologies
  • Timing[4]
    • Onset 12–24 h after abstinence
    • Peak intensity at 20–51 h
    • Duration of 2–9 days

See Also

External Links


  1. Silverman K, et al. Withdrawal syndrome after the double-blind cessation of caffeine consumption. NEJM. 1992; 327(16):1109–1114.
  2. Food Standards Agency (2001) Statement on the Reproductive Effects of Caffeine. London: Food Standards Agency.
  3. Juliano LM and Griffiths RR. Caffeine. In Lowinson, J.H., Ruiz, P., Millman, R.B., Langrod, J.G. (Eds.). Substance Abuse: A Comprehensive Textbook, Fourth Edition. 2005. PP. 403-421. Baltimore: Lippincott, Williams, & Wilkins.
  4. Juliano LM and Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features . Psychopharmacology. 2008; 176(1):1–29.