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Article CommentaryAnalysis and Commentary

Caffeine-Induced Psychosis and a Review of Statutory Approaches to Involuntary Intoxication

John K. Hearn, Thea Reiff, Anne B. McBride and Michael B. Kelly
Journal of the American Academy of Psychiatry and the Law Online May 2020, JAAPL.003923-20; DOI: https://doi.org/10.29158/JAAPL.003923-20
John K. Hearn
Dr. Hearn is Assistant Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri. Ms. Reiff is Office Head and Attorney, Dillon Trial Office of the Colorado Public Defender, Dillon, Colorado. Dr. McBride is Program Director, Child and Adolescent Psychiatry Residency, and Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of California, Davis. Dr. Kelly is Senior Psychiatrist, Coalinga State Hospital, Coalinga, California, and Program Director, Forensic Psychiatry Fellowship, San Mateo County Behavioral Health and Recovery Services, San Mateo, California.
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Thea Reiff
Dr. Hearn is Assistant Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri. Ms. Reiff is Office Head and Attorney, Dillon Trial Office of the Colorado Public Defender, Dillon, Colorado. Dr. McBride is Program Director, Child and Adolescent Psychiatry Residency, and Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of California, Davis. Dr. Kelly is Senior Psychiatrist, Coalinga State Hospital, Coalinga, California, and Program Director, Forensic Psychiatry Fellowship, San Mateo County Behavioral Health and Recovery Services, San Mateo, California.
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Anne B. McBride
Dr. Hearn is Assistant Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri. Ms. Reiff is Office Head and Attorney, Dillon Trial Office of the Colorado Public Defender, Dillon, Colorado. Dr. McBride is Program Director, Child and Adolescent Psychiatry Residency, and Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of California, Davis. Dr. Kelly is Senior Psychiatrist, Coalinga State Hospital, Coalinga, California, and Program Director, Forensic Psychiatry Fellowship, San Mateo County Behavioral Health and Recovery Services, San Mateo, California.
MD
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Michael B. Kelly
Dr. Hearn is Assistant Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri. Ms. Reiff is Office Head and Attorney, Dillon Trial Office of the Colorado Public Defender, Dillon, Colorado. Dr. McBride is Program Director, Child and Adolescent Psychiatry Residency, and Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of California, Davis. Dr. Kelly is Senior Psychiatrist, Coalinga State Hospital, Coalinga, California, and Program Director, Forensic Psychiatry Fellowship, San Mateo County Behavioral Health and Recovery Services, San Mateo, California.
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    Table 1

    Case Reports of Caffeine-Induced Mania and Psychosis

    AuthorSexAge, yClinical PresentationCaffeinated BeverageEstimated Daily Caffeine Intake, mgPreexisting Psychiatric Diagnosis
    Quadri et al9Female17ManiaEnergy drinks600 × 1 weekNone
    Krankl and Gitlin10Female69ManiaCoffee/cola840None
    Cruzado et al11Female31ManiaEnergy drinks1,000–1,810None
    Ogawa and Ueki12Male43ManiaCoffee660–1,320None
    Kunitake et al13Male54ManiaCoffee1,300–2,000Bipolar spectrum
    Machado-Vieira et al14Male36ManiaEnergy drinks300–400Bipolar spectrum
    Tondo and Rudas15Female50ManiaEspresso900–1,500Bipolar spectrum
    Hernandez-Huerta et al16Male18PsychosisEnergy drinks480None
    Govil17Male35PsychosisSource unclear1,600None
    Görgülü et al18Male21PsychosisEnergy drinksUnknownNone
    Hedges et al19Male47PsychosisCoffee“High intake”None
    Shaul et al20Female18PsychosisDiuretic/caffeine pill4,800Anorexia nervosa, no history of psychosis
    Peng et al21Male49PsychosisCoffee600Schizophrenia
    Menkes22Male27PsychosisCoffee, energy drinks600–1,305Schizophrenia
    Cerimele et al23Male43PsychosisEnergy drinks1,280–1,600Schizophrenia
    Tibrewal and Dhillon24Male52PsychosisCoffee960–5,000Schizophrenia
    Lucas et al2512 male, 1 female18–36Psychosis (exacerbation)Intravenous; double-blind placebo, controlled10 mg/kgSchizophrenia
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Journal of the American Academy of Psychiatry and the Law Online: 53 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 53, Issue 1
1 Mar 2025
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Caffeine-Induced Psychosis and a Review of Statutory Approaches to Involuntary Intoxication
John K. Hearn, Thea Reiff, Anne B. McBride, Michael B. Kelly
Journal of the American Academy of Psychiatry and the Law Online May 2020, JAAPL.003923-20; DOI: 10.29158/JAAPL.003923-20

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Caffeine-Induced Psychosis and a Review of Statutory Approaches to Involuntary Intoxication
John K. Hearn, Thea Reiff, Anne B. McBride, Michael B. Kelly
Journal of the American Academy of Psychiatry and the Law Online May 2020, JAAPL.003923-20; DOI: 10.29158/JAAPL.003923-20
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    • Role of Caffeine in Psychiatric Disorders
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