Caffeine-Induced Psychosis: A Case Report and Review of Literature

A 51-year-old female, with no previous history of psychosis, presented to the Emergency Department with an acute psychotic episode in the context of excess caffeine consumption. Caffeine is an adenosine antagonist. An antagonist of adenosine can lead to the release of dopamine into the synaptic cleft, which can induce psychotic symptoms in vulnerable individuals. The patient had consumed caffeine in the form of up to eight energy drinks daily. She experienced persecutory delusions alongside auditory and visual hallucinations. She did not have a history of psychotic disorder but did have a history of generalized anxiety disorder. Upon cessation of caffeine, her symptoms resolved within five days. She remained caffeine-free and symptom-free 18 months later when reviewed in the community. This case highlights the potential psychiatric consequences of excessive caffeine consumption and identifies the need to screen for excessive consumption of caffeine in individuals presenting with new psychotic symptoms or worsening of pre-existing psychotic symptoms.