Caffeine and Antidepressants
For the last decade, antidepressant prescriptions have been on the rise. It's estimated that over a tenth of U.S. adults have used these types of medications at some point. An even more impressive amount of people drink coffee every day - more than 3 out 4 adults.
Adding tea drinkers into the equation leads to almost full coverage of the population. As such, plenty of individuals are consuming both caffeine and antidepressants at the same time. Yet few people are knowledgeable about what the combined effects may be.
Caffeine
Caffeine is a naturally occurring stimulant found in coffee, tea, and various other beverages and foods. It is one of the most widely consumed psychoactive substances in the world.
It works by blocking the action of adenosine, a neurotransmitter that promotes relaxation and sleepiness, thereby increasing alertness and enhancing cognitive function.
The FDA recommends a maximum daily caffeine intake of 400 milligrams for healthy adults, equivalent to about four or five cups of coffee. Certain medical conditions may increase sensitivity or require lowered intake, such as pregnancy.
Antidepressants
Antidepressants are medications primarily prescribed to alleviate symptoms of depression and other psychiatric disorders.
They target neurotransmitters such as serotonin, norepinephrine, and dopamine, which regulate mood, emotions, and motivation.
There are several classes of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and others.
How Caffeine Can Affect Your Antidepressants
Caffeine Intoxication From Fluvoxamine
Fluvoxamine is a selective serotonin reuptake inhibitor and is typically used to treat obsessive-compulsive disorder (OCD).
This antidepressant in particular is known to inhibit the CYP1A2 enzyme, which is responsible for breaking down caffeine. One study showed that the half-life of caffeine increased from 4.9h to a staggering 56h when taken with Fluvoxamine.
This may essentially increase the risk of caffeine intoxication. An overdose of caffeine can lead to symptoms such as headache, fever, nausea, vomiting, ringing in the ears, rapid heart rate, anxiety, trouble sleeping, dizziness, irritability or even seizures.
Slower Metabolism of Older Antidepressants
Related to CYP1A2, this enzyme is not only responsible for metabolizing caffeine but also certain antidepressants like Amitriptyline and Clomipramine.
When caffeine and medications metabolized by CYP1A2 are taken concurrently, competition for the same enzyme typically happens.
As a result, the metabolism of antidepressants processed by this enzyme may be delayed, increasing their effects on the body.
Serotonin Syndrome
In exceptionally rare situations, excessive caffeine intake can trigger serotonin syndrome by increasing serotonin levels, much like certain antidepressants such as Sertraline, Escitalopram, and Venlafaxine.
Serotonin syndrome is a potentially life-threatening condition and the symptoms include heavy sweating, confusion, headache, high blood pressure, rapid heart rate, tremor, dilated pupils, and diarrhea among others.
Coffee and Mental Health
Your daily coffee habit can have certain implications for your mental health conditions. Depending on your conditions and medications, your optimal coffee intake may vary.
For example, research suggests that while moderate coffee consumption may offer some mood-boosting benefits due to its caffeine content, excessive intake could potentially lead to worsened anxiety.
ADHD
Caffeine's effects on individuals with ADHD can vary. Some individuals may experience improved focus and attention with moderate caffeine intake, excessive consumption could exacerbate symptoms such as restlessness, irritability, and insomnia.
Recent randomized controlled trials comparing caffeine to placebo for managing ADHD symptoms in children indicate that caffeine likely provides no real benefit in addressing neither hyperactivity, inattention nor impulsivity.
Anxiety
While smaller amounts of daily caffeine generally are considered safe for individuals with anxiety, excessive intake can worsen anxiety symptoms in susceptible individuals. The stimulatory effects of caffeine on the central nervous system can exacerbate feelings of nervousness, jitteriness, and restlessness.
Tolerance may help to reduce this phenomenon. Regular caffeine consumers frequently find that the stimulating effects become less pronounced over time without adjusting their daily intake. Still, individuals prone to anxiety may find it beneficial to limit their coffee consumption or switch to decaffeinated alternatives.
Depression
A meta-analysis from 2016 studied the link between coffee and caffeine consumption and depression risk. The research paper found that both coffee and caffeine intake were associated with a decreased risk of depression.
Specifically, for each additional cup of coffee consumed daily, the risk of depression decreased by 8%. The association with caffeine became significant when intake ranged between 68 mg and 509 mg per day. The findings suggest that coffee and caffeine may have a protective effect against depression.
Finding The Right Antidepressant
It can be a difficult process to find the antidepressant most suitable to your needs and circumstances, with the least amount of side effects. With the help of your doctor, assess the side effects profile of any antidepressants carefully, as intolerable side effects are a common reason for treatment discontinuation.
For general-purpose guidance, consider taking the antidepressant quiz. It is no substitute for working closely with your prescribing physician, but it may kickstart the conversation with your doctor about potentially suitable options to consider.
Last update: March 20, 2024
Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease or mental illness, seek immediate medical attention.