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Serra M, Simola N, Pollack AE, Costa G. Brain dysfunctions and neurotoxicity induced by psychostimulants in experimental models and humans: an overview of recent findings. Neural Regen Res 2024; 19:1908-1918. [PMID: 38227515 DOI: 10.4103/1673-5374.390971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/10/2023] [Indexed: 01/17/2024] Open
Abstract
Preclinical and clinical studies indicate that psychostimulants, in addition to having abuse potential, may elicit brain dysfunctions and/or neurotoxic effects. Central toxicity induced by psychostimulants may pose serious health risks since the recreational use of these substances is on the rise among young people and adults. The present review provides an overview of recent research, conducted between 2018 and 2023, focusing on brain dysfunctions and neurotoxic effects elicited in experimental models and humans by amphetamine, cocaine, methamphetamine, 3,4-methylenedioxymethamphetamine, methylphenidate, caffeine, and nicotine. Detailed elucidation of factors and mechanisms that underlie psychostimulant-induced brain dysfunction and neurotoxicity is crucial for understanding the acute and enduring noxious brain effects that may occur in individuals who use psychostimulants for recreational and/or therapeutic purposes.
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Affiliation(s)
- Marcello Serra
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
| | - Nicola Simola
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
| | - Alexia E Pollack
- Department of Biology, University of Massachusetts-Boston, Boston, MA, USA
| | - Giulia Costa
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
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Kennedy DO, Wightman EL. Mental Performance and Sport: Caffeine and Co-consumed Bioactive Ingredients. Sports Med 2022; 52:69-90. [PMID: 36447122 PMCID: PMC9734217 DOI: 10.1007/s40279-022-01796-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 12/05/2022]
Abstract
The plant defence compound caffeine is widely consumed as a performance enhancer in a sporting context, with potential benefits expected in both physiological and psychological terms. However, although caffeine modestly but consistently improves alertness and fatigue, its effects on mental performance are largely restricted to improved attention or concentration. It has no consistent effect within other cognitive domains that are important to sporting performance, including working memory, executive function and long-term memory. Although caffeine's central nervous system effects are often attributed to blockade of the receptors for the inhibitory neuromodulator adenosine, it also inhibits a number of enzymes involved both in neurotransmission and in cellular homeostasis and signal propagation. Furthermore, it modulates the pharmacokinetics of other endogenous and exogenous bioactive molecules, in part via interactions with shared cytochrome P450 enzymes. Caffeine therefore enjoys interactive relationships with a wide range of bioactive medicinal and dietary compounds, potentially broadening, increasing, decreasing, or modulating the time course of their functional effects, or vice versa. This narrative review explores the mechanisms of action and efficacy of caffeine and the potential for combinations of caffeine and other dietary compounds to exert psychological effects in excess of those expected following caffeine alone. The review focusses on, and indeed restricted its untargeted search to, the most commonly consumed sources of caffeine: products derived from caffeine-synthesising plants that give us tea (Camellia sinensis), coffee (Coffea genus), cocoa (Theabroma cacao) and guaraná (Paullinia cupana), plus multi-component energy drinks and shots. This literature suggests relevant benefits to mental performance that exceed those associated with caffeine for multi-ingredient energy drinks/shots and several low-caffeine extracts, including high-flavanol cocoa and guarana. However, there is a general lack of research conducted in such a way as to disentangle the relative contributions of the component parts of these products.
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Affiliation(s)
- David O. Kennedy
- Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle-upon-Tyne, NE1 8ST UK
| | - Emma L. Wightman
- Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle-upon-Tyne, NE1 8ST UK
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Overstreet DS, Penn TM, Cable ST, Aroke EN, Goodin BR. Higher habitual dietary caffeine consumption is related to lower experimental pain sensitivity in a community-based sample. Psychopharmacology (Berl) 2018; 235:3167-3176. [PMID: 30187108 PMCID: PMC6204079 DOI: 10.1007/s00213-018-5016-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/29/2018] [Indexed: 01/09/2023]
Abstract
RATIONALE Caffeine is the most widely consumed psychoactive substance in the world. Caffeine administered acutely in a laboratory environment or as a medication adjuvant has known properties that help alleviate pain. However, much less is known about the potential impact of habitual dietary caffeine consumption on the experience of pain. OBJECTIVES The primary objective of this observational study was to determine whether caffeine consumed habitually as part of a daily diet was associated with experimental pain sensitivity using noxious stimuli in a non-clinical sample of 62 community-dwelling adults between 19 and 77 years old. METHODS Study participants monitored their daily dietary caffeine consumption (e.g., coffee, tea, soda, energy drinks, and chocolate) across a period of seven consecutive days using a caffeine consumption diary. On the seventh day of caffeine consumption monitoring, participants presented to the laboratory to complete experimental pain sensitivity testing. Noxious thermal and mechanical stimuli were used to obtain threshold and tolerance for painful heat and pressure, respectively. RESULTS Data analysis revealed that greater self-reported daily caffeine consumption was significantly associated with higher heat pain threshold (β = .296, p = .038), higher heat pain tolerance (β = .242, p = .046), and higher pressure pain threshold (β = .277, p = .049) in multiple regression models adjusted for covariates. CONCLUSIONS Results of this study completed with community-dwelling adults revealed that individuals who habitually consume greater amounts of caffeine as part of their daily diets demonstrate diminished sensitivity to painful stimuli in a laboratory setting.
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Affiliation(s)
| | - Terence M. Penn
- Department of Psychology, University of Alabama at Birmingham
| | - Sarah T. Cable
- Department of Psychology, University of Alabama at Birmingham
| | - Edwin N. Aroke
- School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, & Continuing Care, & University of Alabama at Birmingham
| | - Burel R. Goodin
- Department of Psychology, University of Alabama at Birmingham,Department of Anesthesiology & Perioperative Medicine, Division of Pain Medicine, University of Alabama at Birmingham,Corresponding author: Tel.: +1-205-934-8910; fax: +1-205-975-6110. .,B.Goodin, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 327E, Birmingham, AL 35294
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Caffeine and cardiovascular health. Regul Toxicol Pharmacol 2017; 89:165-185. [DOI: 10.1016/j.yrtph.2017.07.025] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/21/2017] [Accepted: 07/23/2017] [Indexed: 02/07/2023]
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Caffeine Induces a Stimulant Effect and Increases Dopamine Release in the Nucleus Accumbens Shell Through the Pulmonary Inhalation Route of Administration in Rats. Neurotox Res 2016; 31:90-98. [PMID: 27631327 DOI: 10.1007/s12640-016-9667-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/11/2016] [Accepted: 08/30/2016] [Indexed: 02/06/2023]
Abstract
Oral, intraperitoneal, or intravenous have been the common routes of administration used to study the behavioral and neurochemical pharmacology of caffeine, one of the most widely used psychoactive substances worldwide. We have reported that caffeine is an active adulterant frequently found in coca-paste (CP)-seized samples, a highly addictive form of smokable cocaine. The role of caffeine in the psychostimulant and neurochemical effects induced by CP remains under study. No preclinical animal studies have been performed so far to characterize the effects of caffeine when it is administered through the pulmonary inhalation route. Caffeine (10, 25, and 50 mg) was volatilized and rats were exposed to one inhalation session of its vapor. The stimulant effect was automatically recorded and plasmatic levels of caffeine were measured. Caffeine capability (50 mg) to increase extracellular dopamine (DA) levels in nucleus accumbens shell was also studied by in vivo microdialysis in non-anesthetized animals. A dose-dependent stimulant effect induced by volatilized caffeine was observed and this effect was directly related with caffeine plasmatic levels. A significant increase in the extracellular DA was achieved after 50 mg of volatilized caffeine exposure. This is the first report showing pharmacological acute effects of caffeine through the pulmonary inhalation route of administration and suggests that this could be a condition under which caffeine can elevate its weak reinforcing effect and even enhance the psychostimulant effect and abuse liability of smokable adulterated psychostimulant drugs.
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Turnbull D, Rodricks JV, Mariano GF. Neurobehavioral hazard identification and characterization for caffeine. Regul Toxicol Pharmacol 2016; 74:81-92. [DOI: 10.1016/j.yrtph.2015.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/01/2015] [Accepted: 12/09/2015] [Indexed: 02/04/2023]
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Simola N, Costa G, Morelli M. Activation of adenosine A₂A receptors suppresses the emission of pro-social and drug-stimulated 50-kHz ultrasonic vocalizations in rats: possible relevance to reward and motivation. Psychopharmacology (Berl) 2016; 233:507-19. [PMID: 26564233 DOI: 10.1007/s00213-015-4130-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/18/2015] [Indexed: 12/31/2022]
Abstract
RATIONALE Rats emit 50-kHz ultrasonic vocalizations (USVs) in response to pleasurable stimuli, and these USVs are considered a tool for investigating reward and motivation. OBJECTIVES This study aimed to clarify how activity of adenosine A2A receptors, which modulate reward and motivation, influences 50-kHz USV emission in rats. METHODS Rats received one of the following treatments in a test cage: (1) acute administration of the A2A receptor agonist CGS 21680 (0.05-0.2 mg/kg, i.p.) during social interactions; (2) long-term amphetamine (1 or 2 mg/kg, i.p.) or morphine (7.5 mg/kg, s.c.) administration on alternate days, alone or with CGS 21680, followed after 7 days of discontinuation by test cage re-exposure, to assess drug-conditioning effects, and thereafter drug challenge; (3) acute administration of the D1/D2 receptor agonist apomorphine (4 mg/kg, i.p.), alone or with CGS 21680; and (4) long-term administration of the non-selective A1/A2A receptor antagonist caffeine (15 mg/kg, i.p.), on alternate days. USVs and locomotor activity were evaluated throughout the treatments. RESULTS CGS 21680 attenuated 50-kHz USV emission stimulated by social interactions, amphetamine, apomorphine, and morphine, and rats administered CGS 21680 with amphetamine or morphine emitted fewer conditioned 50-kHz USVs upon test cage re-exposure, compared with rats administered amphetamine or morphine alone. Moreover, CGS 21680 administration prevented long-term changes in locomotor activity in amphetamine- and morphine-treated rats. Finally, caffeine had no effect on 50-kHz USVs. CONCLUSIONS These results indicate that activation of A2A receptors attenuates 50-kHz USV emission in rats and further elucidate how these receptors modulate the motivational properties of natural and pharmacological stimuli.
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Affiliation(s)
- Nicola Simola
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale, 72, 09124, Cagliari, Italy.
| | - Giulia Costa
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale, 72, 09124, Cagliari, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale, 72, 09124, Cagliari, Italy.,CNR, National Research Council of Italy, Neuroscience Institute, Cagliari, Italy
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Frau L, Costa G, Porceddu PF, Khairnar A, Castelli MP, Ennas MG, Madeddu C, Wardas J, Morelli M. Influence of caffeine on 3,4-methylenedioxymethamphetamine-induced dopaminergic neuron degeneration and neuroinflammation is age-dependent. J Neurochem 2015; 136:148-62. [DOI: 10.1111/jnc.13377] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/02/2015] [Accepted: 09/03/2015] [Indexed: 02/03/2023]
Affiliation(s)
- Lucia Frau
- Department of Biomedical Sciences; Section of Neuropsychopharmacology; University of Cagliari; Cagliari Italy
| | - Giulia Costa
- Department of Biomedical Sciences; Section of Neuropsychopharmacology; University of Cagliari; Cagliari Italy
| | - Pier Francesca Porceddu
- Department of Biomedical Sciences; Section of Neuropsychopharmacology; University of Cagliari; Cagliari Italy
| | - Amit Khairnar
- Applied Neuroscience Research Group; CEITEC - Central European Institute of Technology; Masaryk University; Brno Czech Republic
| | - Maria Paola Castelli
- Department of Biomedical Sciences; Section of Neuroscience and Clinical Pharmacology; University of Cagliari; Monserrato (CA) Italy
| | - Maria Grazia Ennas
- Department of Biomedical Sciences; Section of Neuroscience and Clinical Pharmacology; University of Cagliari; Monserrato (CA) Italy
| | - Camilla Madeddu
- Department of Biomedical Sciences; Section of Neuroscience and Clinical Pharmacology; University of Cagliari; Monserrato (CA) Italy
| | - Jadwiga Wardas
- Department of Neuropsychopharmacology; Institute of Pharmacology; Polish Academy of Sciences; Krakow Poland
| | - Micaela Morelli
- Department of Biomedical Sciences; Section of Neuropsychopharmacology; University of Cagliari; Cagliari Italy
- CNR; Institute of Neuroscience; Cagliari Italy
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Prieto JP, Galvalisi M, López-Hill X, Meikle MN, Abin-Carriquiry JA, Scorza C. Caffeine enhances and accelerates the expression of sensitization induced by coca paste indicating its relevance as a main adulterant. Am J Addict 2015; 24:475-81. [PMID: 25974755 DOI: 10.1111/ajad.12245] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 04/14/2015] [Accepted: 04/26/2015] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caffeine is an active adulterant found in several drugs of abuse including coca paste (CP). We had previously demonstrated that caffeine potentiated the acute stimulant effect induced by CP seized samples. The role of caffeine in the expression of sensitization elicited by a CP seized sample (CP1) was here evaluated. METHODS CP1 (equivalent dose of 10 mg/kg of cocaine), cocaine (pure, 10 mg/kg), a combination of cocaine 10 mg/kg plus caffeine 2.5 mg/kg (CP1-surrogate) and saline (control) were intraperitoneally injected in male rats under two different sensitization schedules. Ambulatory locomotion was recorded in 58 animals. RESULTS After five daily CP1 injections and 5 days of withdrawal, CP1-challenged animals displayed a more robust sensitization than cocaine-treated animals. When a 3 injections-regime of CP1-surrogate or cocaine was assayed, only CP1-surrogate was able to elicit sensitization. DISCUSSION AND CONCLUSIONS Caffeine enhances and accelerates the CP1-induced sensitization. SCIENTIFIC SIGNIFICANCE Results may shed light on the fast and high dependence observed in CP users.
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Affiliation(s)
- José P Prieto
- Departamento de Neurofarmacología Experimental, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, Uruguay
| | - Martín Galvalisi
- Departamento de Neurofarmacología Experimental, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, Uruguay
| | - Ximena López-Hill
- Departamento de Neurofarmacología Experimental, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, Uruguay
| | - María N Meikle
- Laboratorio de Biología Celular, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, Uruguay
| | - Juan A Abin-Carriquiry
- Departmento de Neuroquímica, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, Uruguay
| | - Cecilia Scorza
- Departamento de Neurofarmacología Experimental, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, Uruguay
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Abstract
The latest edition of the Diagnostic and Statistical Manual (DSM-5) has introduced new provisions for caffeine-related disorders. Caffeine Withdrawal is now an officially recognized diagnosis, and criteria for caffeine use disorder have been proposed for additional study. caffeine use disorder is intended to be characterized by cognitive, behavioral, and physiological symptoms indicative of caffeine use despite significant caffeine-related problems, similar to other Substance Use Disorders. However, since nonproblematic caffeine use is so common and widespread, it may be difficult for some health professionals to accept that caffeine use can result in the same types of pathological behaviors caused by alcohol, cocaine, opiates, or other drugs of abuse. Yet there is evidence that some individuals are psychologically and physiologically dependent on caffeine, although the prevalence and severity of these problems is unknown. This article reviews the recent changes to the DSM, the concerns regarding these changes, and some potential impacts these changes could have on caffeine consumers.
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Meikle MN, Prieto JP, Urbanavicius J, López X, Abin-Carriquiry JA, Prunell G, Scorza MC. Anti-aggressive effect elicited by coca-paste in isolation-induced aggression of male rats: Influence of accumbal dopamine and cortical serotonin. Pharmacol Biochem Behav 2013; 110:216-23. [DOI: 10.1016/j.pbb.2013.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 07/09/2013] [Accepted: 07/13/2013] [Indexed: 10/26/2022]
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Frau L, Simola N, Morelli M. Contribution of Caffeine to the Psychostimulant, Neuroinflammatory and Neurotoxic Effects of Amphetamine-Related Drugs. JOURNAL OF CAFFEINE RESEARCH 2013. [DOI: 10.1089/jcr.2013.0007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Lucia Frau
- Section of Neuropsychopharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Nicola Simola
- Section of Neuropsychopharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Micaela Morelli
- Section of Neuropsychopharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- Centre of Excellence for Neurobiology of Dependence, University of Cagliari, Cagliari, Italy
- CNR, Institute of Neuroscience, Cagliari, Italy
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López-Cruz L, Salamone JD, Correa M. The Impact of Caffeine on the Behavioral Effects of Ethanol Related to Abuse and Addiction: A Review of Animal Studies. JOURNAL OF CAFFEINE RESEARCH 2013; 3:9-21. [PMID: 24761272 PMCID: PMC3643311 DOI: 10.1089/jcr.2013.0003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The impact of caffeine on the behavioral effects of ethanol, including ethanol consumption and abuse, has become a topic of great interest due to the rise in popularity of the so-called energy drinks. Energy drinks high in caffeine are frequently taken in combination with ethanol under the popular belief that caffeine can offset some of the intoxicating effects of ethanol. However, scientific research has not universally supported the idea that caffeine can reduce the effects of ethanol in humans or in rodents, and the mechanisms mediating the caffeine-ethanol interactions are not well understood. Caffeine and ethanol have a common biological substrate; both act on neurochemical processes related to the neuromodulator adenosine. Caffeine acts as a nonselective adenosine A1 and A2A receptor antagonist, while ethanol has been demonstrated to increase the basal adenosinergic tone via multiple mechanisms. Since adenosine transmission modulates multiple behavioral processes, the interaction of both drugs can regulate a wide range of effects related to alcohol consumption and the development of ethanol addiction. In the present review, we discuss the relatively small number of animal studies that have assessed the interactions between caffeine and ethanol, as well as the interactions between ethanol and subtype-selective adenosine receptor antagonists, to understand the basic findings and determine the possible mechanisms of action underlying the caffeine-ethanol interactions.
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Affiliation(s)
| | - John D. Salamone
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Mercè Correa
- Àrea de Psicobiologia, Universitat Jaume I, Castelló, Spain
- Department of Psychology, University of Connecticut, Storrs, Connecticut
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Caffeine in the treatment of pain. Rev Bras Anestesiol 2012; 62:387-401. [PMID: 22656684 DOI: 10.1016/s0034-7094(12)70139-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 08/29/2011] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Caffeine is a widely used substance with effects on several systems, presenting characteristic of pharmacokinetic and pharmacodynamic which cause interactions with several drugs. This study's objective is to review the effects caused by caffeine. CONTENT This review assesses the caffeine pharmacology, its action mechanisms, indications, contraindications, doses, interactions and adverse effects. CONCLUSIONS There are insufficient double-blind randomized controlled studies that assess the analgesic effect of caffeine on several painful syndromes. Patients presenting chronic pain need caution when it comes to tolerance development, abstinence and drug interaction from chronic caffeine use.
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Vanattou-Saïfoudine N, McNamara R, Harkin A. Caffeine provokes adverse interactions with 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') and related psychostimulants: mechanisms and mediators. Br J Pharmacol 2012; 167:946-59. [PMID: 22671762 PMCID: PMC3492978 DOI: 10.1111/j.1476-5381.2012.02065.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 05/04/2012] [Accepted: 05/18/2012] [Indexed: 11/27/2022] Open
Abstract
Concomitant consumption of caffeine with recreational psychostimulant drugs of abuse can provoke severe acute adverse reactions in addition to longer term consequences. The mechanisms by which caffeine increases the toxicity of psychostimulants include changes in body temperature regulation, cardiotoxicity and lowering of the seizure threshold. Caffeine also influences the stimulatory, discriminative and reinforcing effects of psychostimulant drugs. In this review, we consider our current understanding of such caffeine-related drug interactions, placing a particular emphasis on an adverse interaction between caffeine and the substituted amphetamine, 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'), which has been most recently described and characterized. Co-administration of caffeine profoundly enhances the acute toxicity of MDMA in rats, as manifested by high core body temperature, tachycardia and increased mortality. In addition, co-administration of caffeine enhances the long-term serotonergic neurotoxicity induced by MDMA. Observations to date support an interactive model of drug-induced toxicity comprising MDMA-related enhancement of dopamine release coupled to a caffeine-mediated antagonism of adenosine receptors in addition to inhibition of PDE. These experiments are reviewed together with reports of caffeine-related drug interactions with cocaine, d-amphetamine and ephedrine where similar mechanisms are implicated. Understanding the underlying mechanisms will guide appropriate intervention strategies for the management of severe reactions and potential for increased drug-related toxicity, resulting from concomitant caffeine consumption.
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Affiliation(s)
- N Vanattou-Saïfoudine
- Neuropsychopharmacology Research Group, School of Pharmacy and Pharmaceutical Sciences & Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
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Abstract
Nonprescription drug, also referred to as over-the-counter (OTC) abuse, is a serious and growing global health challenge. Drugs from many different therapeutic classes and numerous dosage forms and drug delivery systems are implicated in nonprescription drug abuse. Individuals who commonly abuse certain nonprescription medications are likewise diverse, varying in age, demographics, and overall health status. The clinician is in a unique position to assist in identifying those patients at risk for nonprescription drug abuse and those who are abusers, and may play an important role in intervention, patient care, and in the treatment of nonprescription drug abuse. A concise review of nonprescription drug abuse may be of use to the clinician in this regard.
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