ache plus one or more other symptoms as well as functional impairment. Caffeine con-
sumers can decrease the incidence of caffeine withdrawal by using ca ffeine daily or only
infrequently (e.g., no more than 2 consecutive days). Gradual reductio n in caffeine over a
period of days or weeks may decrease the incidence and severity of caffeine withdrawal. 
Development and Course
Symptoms usually begin 12–24 hours after the last caffeine dose and peak after 1–2 days
of abstinence. Caffeine withdrawal symptoms last for 2–9 days, with the possibility of
withdrawal headaches occurring for up to  21 days. Symptoms usually remit rapidly
(within 30–60 minutes) after re-ingestion of caffeine. 
Caffeine is unique in that it is a behavioral ly active drug that is consumed by individ-
uals of nearly all ages. Rates of caffeine consumption and overall level of caffeine con-
sumption increase with age until the early to mid-30s and then level off. Although caffeine
withdrawal among children and adolescents has been documented, relatively little is
known about risk factors for caffeine withdrawal among this age group. The use of highly
caffeinated energy drinks is increasing with  in young individuals, which could increase
the risk for caffeine withdrawal. 
Risk and Prognostic Factors 
Temperamental. Heavy caffeine use has been observ ed among individuals with mental
disorders, including eating disorders; smoker s; prisoners; and drug and alcohol abusers.
Thus, these individuals could be at higher risk for caffeine withdrawal upon acute caffeine
abstinence.
Environmental. The unavailability of caffeine is an environmental risk factor for incipi-
ent withdrawal symptoms. While caffeine is le gal and usually widely available, there are
conditions in which caffeine use may be restricted, such as during medical procedures,