الفهرس 
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Abstract
C
affeine is the most commonly used psychoactive drug throughout the world that has overcome resistance and disapproval to the extent that it is freely available for
every one almost everywhere. Many people consider caffeine ”harmless, and do not realize the potentially severe health effects it can lead to until they’ve overdosed. Psychiatrists rarely enquire about caffeine intake when assessing their patients. This may lead to a failure to identify caffeine-related problems and offer appropriate interventions when needed.Four caffeine-related psychiatric syndromes are recognized in DSM –IV-TR: caffeine intoxication; caffeineinduced anxiety disorder; caffeine-induced sleep disorder; and caffeine-related disorder not otherwise specified. ICD-10 includes caffeine-related disorders in its “Other Stimulant” class which also includes amphetamines.Two types of presentation for caffeine intoxication have been identified, the acute form (intoxication ) and the chronic one (caffeinism ). The condition is characterized by restlessness, agitation, excitement, incoherent, rambling thoughts and speech, and insomnia, flushed face, dieresis, GIT disturbance, muscle twitching, tachycardia or cardiac arrhythmia and periods of inexhaustibility. DSM-IV-TR also stipulates that recent consumption of caffeine, usually in excess of 250 mg (e.g., more than 2–3 cups of brewed coffee ) .Epidemiological data are lacking. However, high risk group includes persons who use caffeine to enhance academic or professional performance or to maintain alertness for extended periods of time, psychiatric patients especially the schizophrenic ones, and adolescents who tend to undergo vigorous advertising and huge marketing of energy drinks. For managing these patients, caffeine blood levels can be obtained,but their practical use as a screening tool is limited. No other specific tests detect caffeine-induced psychiatric disorders. Persons with persistent insomnia, particularly if the history is inconclusive, might benefit from a referral for a sleep study. Cardiac irregularities, whether caffeine induced or not, should be investigated using ECG. Patients with caffeine intoxication generally have a good prognosis. However reassuring vital signs and serum electrolytes is crucial in some cases. Other methods of enhanced elimination encompass charcoal hemoperfusion, hemo-dialysis, peritoneal dialysis, and exchange transfusion . Gradual reductions in caffeine use arerecommended to avoid withdrawal. The use of decaffeinated alternatives and the programs based on techniques of behavior management have proved successful.