Caffeine reinforcement: the role of withdrawal.

This study examined caffeine's acute and withdrawal effects in moderate caffeine consumers (mean = 379 mg/day caffeine) to compare the relative contributions each might have to caffeine reinforcement. Subjects were caffeine restricted on the night before each of three sessions, which generally occurred at weekly intervals; these restrictions lasted until the session was completed approximately 19 h later. During the first two sessions, subjects received either placebo or caffeine (each subject's average daily intake). These two conditions occurred using a double-blind, quasi-random, crossover design. At the end of each session subjects completed the POMS, a caffeine withdrawal questionnaire, and a Multiple-Choice Form on which subjects made a series of discrete choices between receiving the drug again or receiving varying amounts of money. This form also included negative money amounts to assess how much subjects would forfeit to avoid placebo (e.g., withdrawal symptoms after placebo). During the third session, one of the previous choices was randomly selected and the consequence of that choice was implemented. Placebo increased self-reported feelings of "worn out," "headache," and "flu-like feelings," and decreased "alert," "upset stomach," "helpful," and "well-being" relative to caffeine. On the Multiple-Choice Forms, subjects chose to receive caffeine rather than an average of $0.38 and to forfeit $2.51 to avoid receiving placebo again. "Headache" was significantly correlated with amount of money forfeited to avoid placebo. These results suggest that, under these conditions, choice of caffeine is more potently controlled by avoiding withdrawal than it is by the positive effects of caffeine.

RCT Entities:   Population Interventions Outcomes