Caffeine Intoxication: An Analysis of Published Case Reports, 1883–2023

Area of Science:

• Toxicology
• Clinical Medicine
• Pharmacology

Background:

• Limited systematic data exists on acute caffeine intoxication despite numerous case reports.
• Previous research lacks prospective, epidemiologic, or guideline-based studies for caffeine overdose management.

Purpose of the Study:

• To analyze published case reports on acute caffeine intoxication.
• To describe the clinical presentation and treatment of caffeine overdose.

Main Methods:

• Systematic review of case reports from 1851-2023.
• Searched PubMed, Google Scholar, and Semantic Scholar databases.
• Keywords included: "caffeine intoxication," "caffeine poisoning," and "caffeine overdose."

Main Results:

• Analyzed 216 individual cases of caffeine intoxication.
• Median intoxication dose: 12g; median serum concentration: 160 mg/L.
• Suicidal intent (40%), accidental (22%), and treatment errors (6%) were causes; 21% of accidental cases involved minors.
• Convulsions and wide-complex tachycardias correlated with worse outcomes.
• Extracorporeal hemodialysis showed effectiveness in caffeine elimination and improved survival.

Conclusions:

• This is the largest analysis of caffeine intoxication cases to date.
• Definitive treatment recommendations are not yet possible.
• Hemodialysis is a viable option for potentially lethal ingestions or severe clinical courses.