Newsgroups: alt.drugs From: [g--b--t] at [utkvx.utk.edu] (Garbett, Shawn) Subject: Caffine/Coffee Date: Tue, 10 May 1994 23:42:00 GMT Here's the long awaited post about Caffeine/Coffee that I promised. It's from the book _Clinical_Management_of_Poisoning_and_Drug_Overdose, by Haddad Winchester, pg 509-512. I've cut out the text that primarily deals with the mental effects of coffee and left the stuff out about what it does to your heart, mainly just that it can cause irregular heart rhythms. ... Caffeine is quickly absorbed in the oral, rectal,and subcutaneous routes--all of which test nearly equally toxic in cats, rats, and dogs. It is rapidly metabolized and excreted in the urine in almost equal parts as 1-methyluric acid and 1-methylxanthine. About 10 per cent of the caffeine is excreted unchanged. The half-life of caffeine is about 3.5 hours. Caffeine appears to stimulate the synthesis and release of catecholamines, especially norepinephrine. A mild decrease in glucose tolrance following caffeine ingestion may be due to the catecholamine and subsequent cyclic AMP increase. Caffeine also induces hepatic drug-metabolizing enzymes. The significance at this time in humans in not known. ... Text on how children have a much higher half-life of caffeine in the body and how it can thus poison them. .... ... Caffeine has wide-ranging physiologic effects. It is distributed throughout all organ systems in proportion to body water. Passing the bloood-brain barrier as well as the placental barrier readily, it is known to stimulate the meduallary, respiratory, vasomotor and vagal centers. At high doses, the spinal cord is stimulated. Whether regular consumption of caffeine diminishes its stimulant effects is a significant question. ... As noted, patients with caffeine-induced psychosis, whether it be delirium, manic depression, schizophrenia, or merely an anxiety syndrome, in most cases will be hard to differentiate from other organic or non-organic psychoses. The differential diagnosis also is important in hyperkinetic children who have been exposed to caffeine. The treatment for caffeine-induced psychosis is to withhold further caffeine. (Duh!) .. Caffeine toxicity can be both acute or, more commonly, chronic or seen in a withdrawal state. Despite caffeine's wide use, few deaths are reported in the literature. This may be due to both the emetic effect of caffeine and general ignorance among lay people concering the lethal effects of caffeine. Although no fatalities are reported from coffee drinking, some of the first reports of toxicity from caffeine were reported by Curschmann in 1873, Fort in 1883, and Lewin in 1897. Some reports dealt with ingestions of a high-strength coffee-like preparation of coffee beans containing up to 5 grams of caffeine. The acute oral lethal dose of caffeine in the adult is considered to be greater than 10 grams, or more than 1750 mg/kg. The dose is considerably lower in children. Toxic symptoms can be produced in the adult with 1 gram or more of oral caffeine. (That's about 10 cups of coffee) The spectrum of clinical toxicity of caffeine poisoning is rather wide. Many of the symptoms are based on the stimulatory effect on the central nervous and circulatory systems. Initial effects may include insomnia dyspnea, and excitement progressing to a mild delirium. There may be alternating states on conciousness and muscle twitching. Subsequent symptoms may include diuresis; arrhythmias, including tachycardias and extrasystoles; palpitations; and photophobia (AAAHHHH The light--editor). The terminal event, which in some cases has been the intial presentation, normally is seizures. Hyperglycemia nd ketonuria also have been reported. .. A cola-induced psychosis has been reported (4) Twenty cases of "syndrome of coffee" have been described, with symptoms including tinnitus, nausea, projectile vomiting, arrhythmia, and inability to walk. (Alright buddy, just how many cups of coffee did you drink? --editor) Cases of caffeine-induced manic-depression and coffee-induced exacerbation of schizophrenic processes also have been seen. (5) Caffeine-induced psychoses ranged from tincreased agitation and insomnia to frank psychosis. The psychoses appeared to relate to previous underlying psychiatric disease. This has been shown in some cases to be improved, and antipsychotic or antidepressant agents to be more effective, with the reduction or discontinuance of caffeine in the diet. ... Curschmann in 1873 -- Curschmann H: Ein Fall von Kaffee-intoxxication. Deutsche Klinik 11:377, 1873 Fort JA: Des effets physiologiques du cafe': d'apres des experiences faites sur l'auteur. Bull Gen Therap Paris, 1883, p 550 Lewin L: Coffea arabica L., in Lehrbuch der Toxikologie. Urban and Schwarzenberg, Berlin, 1897, p 311 (4) Shen WW, D'Souza TC: Cola-induced psychotic organic brain-syndrome. Rocky Mtn Med J 76:312-313 (5) 2 references: Mikkelsen EJ: Caffeine and schizophrenia. J Clin Psychiat 39:732, 1978 McManamy MC, Schube PG: Caffeine intoxication. Report of a case the symptoms of which amounted to a psychosis. N Engl J Med 215:616, 1936 You didn't think that cup had it in it did you? Shawn Garbett Stop the WOsD!!!!!