Primary caffeine dependence: a case report

We present a case of primary caffeine dependence based on the exclusive use of over-the-counter caffeine tablets. Caffeine has recently undergone scrutiny as a co-morbid risk factor with other substance dependencies, and in other medical and psychiatric conditions. Caffeine withdrawal also is briefly discussed with attention given to personality factors and the use of nicotine. Although caffeine generally is considered safe in usual doses, it is a substance potentially able to result in serious dependence. We cite a case which also illustrates that a supportive inpatient milieu may be necessary in order to interrupt a cycle of heavy caffeine use resulting in marked dependence.