Randomized controlled trial of a remote-guided caffeine reduction intervention

Caffeine is the most widely used psychoactive substance. Although one third of individuals who chronically consume caffeine express a desire to reduce caffeine consumption, empirically supported interventions for caffeine reduction are limited. This fully-remote randomized controlled trial assessed a manualized caffeine fading intervention for reducing caffeine use and adverse caffeine-related symptoms.

In this two-arm, parallel, open-label waitlist control study, healthy adults with interest in reducing their caffeine consumption and reported adverse caffeine-related symptoms were urn randomized to receive a caffeine fading treatment manual immediately or after a six-week delay. The manual guided participants in systematically reducing caffeine consumption over the six-week intervention. Caffeine-related symptoms were also measured throughout the intervention and up to 14 weeks post-treatment.

Data were analyzed for all randomized participants, with 56 in the delayed treatment group and 53 in the immediate treatment group. Caffeine consumption decreased from a mean of 565mg per day (SD=295) at screening to 233mg (SD=226) post treatment (p < .0001, d=1.26). Caffeine consumption in the delayed treatment group did not significantly decrease prior to the intervention. Reductions were also seen in adverse caffeine-related symptoms, with decreases in PROMIS t-scores for sleep, anxiety, reflux, and diarrhea (d=0.67-1.04).

Participants successfully reduced caffeine use using the manual, showing its feasibility as a standalone intervention. This is the first clinical trial of caffeine reduction treatment done without clinical supervision. Future efforts should increase accessibility by adapting the manual to digital modalities.