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Depression and Caffeine

From: Clinical Psychopharmacology Made Ridiculously Simple, Edition 6 by John Preston, Psy D. & James Johnson, M.D.

It is very important to note that it is common during periods of depression for patients to significantly increase their use of caffeine. Caffeine of course combats fatigue, but it also  has mild transient antidepressant actions, and thus people gravitate toward increasing use. This results in a commonly overlooked complication to treatment: caffeine amounts in excess of 250mg. per day can contribute to a decrease in slow wave (deep) sleep; slow wave sleep is already decreased in depression and the further erosion of this form of sleep can often worsen depression. Caffeine also contributes to restless sleep and frequent awakenings during the night. It is important for patients to know that this effect can occur even in the absence of initial insomnia.

With depression, ever attempt should be made to keep caffeine consumption below 250mg a day (and preferably used only in the morning).

Abby Scuito and Dr. Mallard ("Ducky"), NCIS on CBS

How do you know if you have had too much caffeine?  Here are some signals, based on the DSM-IV diagnostic criteria for caffeine intoxication.

Recent consumption of more than 250mg of caffeine (more than 2-3 cups of brewed coffee).

  • Restlessness
  • Nervousness
  • Excitement
  • Insomnia
  • Flushed face
  • An increased excretion of urine
  • Gastrointestinal disturbance
  • Muscle twitching
  • Rambling flow of thoughts and speech
  • Rapid or abnormal heart beat
  • Periods of exhaustibility

If you experience several (five or more) of these symptoms and they are disruptive to your life or feeling well, you may want to consider reducing your caffeine intake. Particularly with heart disturbances, you may want to consult a doctor if you feel these symptoms, especially if they persist in the absence of caffeine.

For fun: Caffeine Test


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