Caffeine Withdrawal 507
The probability and severity of caffeine with drawal generally increase as a function of
usual daily caffeine dose. However, there is large variability among individuals and
within individuals across different episodes in  the incidence, severity, and time course of
withdrawal symptoms. Caffeine withdrawal sy mptoms may occur after abrupt cessation
of relatively low chronic daily doses of caffeine (i.e., 100 mg).
Associated Features Supporting Diagnosis
Caffeine abstinence has been shown to be as sociated with impaired behavioral and cogni-
tive performance (e.g., sustai ned attention). Electroencepha lographic studies have shown
that caffeine withdrawal symptoms are significantly associated with increases in theta
power and decreases in beta-2 power. Decre ased motivation to work and decreased socia-
bility have also been reported during caffe ine withdrawal. Increased analgesic use during
caffeine withdrawal has been documented.
Prevalence
More than 85% of adults and children in th e United States regularly consume caffeine,
with adult caffeine consumers ingesting abou t 280 mg/day on average. The incidence and
prevalence of the caffeine withdrawal syndro me in the general population are unclear. In
the United States, headache may occur in a pproximately 50% of cases of caffeine absti-
nence. In attempts to permanently stop caffein e use, more than 70% of individuals may ex-
perience at least one caffeine withdrawal sy mptom (47% may experience headache), and
24% may experience headache plus one or more other symptoms as well as functional
impairment due to withdrawal. Among individu als who abstain from caffeine for at least
24 hours but are not trying to permanently stop caffeine use, 11% may experience head-
ache plus one or more other symptoms as well as functional impairment. Caffeine con-