NRSC 4132 Blog

How effective is your caffeine in the morning?
"Caffeine, a widely consumed adenosine A1 and A2A receptor antagonist, is valued as a psychostimulant, but it is also anxiogenic. An association between a variant within the ADORA2A gene (rs5751876) and caffeine-induced anxiety has been reported for individuals who habitually consume little caffeine." How many cups do you drink in the morning before you feel like you are ready to take on the day? The average intake of caffeine is on average was 346 mg per day (equivalent to about three cups of ground coffee per day). What if I were to tell you that the coffee you are drinking scientifically isn?t helping that fatigue. "Although frequent consumers feel alerted by caffeine, especially by their morning tea, coffee, or other caffeine-containing drink, evidence suggests that this is actually merely the reversal of the fatiguing effects of acute caffeine withdrawal (James and Rogers, 2005; Sigmon et al, 2009)."

What if I were to tell you that caffeine has a negative side effect to your health, would you continue to drink it? Caffeine has been linked to hypertension, increased anxiety, nervousness, irritability and nausea. So why can coffee taste that good but have some many side effects? "These behavioral and physiological effects of caffeine occur primarily through antagonism by caffeine of the action of endogenous adenosine at adenosine A1 and A2A receptors (Fredholm et al, 1999)." This study has linked a SNP between caffeine and increased anxiety. "Specifically, it was found that 150 mg caffeine (equivalent to the amount of caffeine present in, eg, 1½ cups of ground coffee) increased anxiety in individuals carrying the TT genotype of the ADORA2A SNP rs5751876, but not in the CT and CC genotype groups (Alsene et al, 2003; Childs et al, 2008)." This study took 218 women and 198 men and administered two doses of caffeine 100mg in the morning and 150 mg shortly after. There was randomization on who would receive caffeine and who would have a placebo. The group of people took a pre-survey to make sure that all caffeine users drank approximately the same amount of caffeine. The day before the study, subjects were not allowed to drink anything that had caffeine in it. Surveys were given to check the anxiety, alertness and quality of headache.

"Another key finding of this study is that a clear anxiogenic effect of caffeine, larger i individuals with the ADORA2A rs5751876 TT genotype, was observed only for people who habitually consumed little or no caffeine (the N and L groups). Higher caffeine consumption appears to lead to substantial tolerance to this effect." They discovered that people who continue to drink caffeine at a high enough rate didn't experience the increased side-effects. They discovered that the subjects developed a tolerance to the caffeine. "Although frequent caffeine consumers experience minimal increased anxiety after caffeine consumption, they are at risk of at least two clear adverse effects of acute caffeine abstinence, namely low alertness and increased headache."

To sum it up people who are habitual users do not develop adverse side effects until they withdraw from the caffeine use. There is also research that has linked a SNP to increased anxiety secondary to caffeine assumption.
For reading of full article please visit http://www.nature.com/npp/journal/v35/n9/full/npp201071a.html

In Mike Nichols film "The Birdcage," Albert played by Nathan Lane, is an insecure, emotional-rollercoaster drag queen whose partner Armand, played by Robin Williams, is an unwavering, cautious entrepreneur. Albert's insecurities get the best of him on stage in addition to his relationship woes that cause him to act in a neurotically unstable fashion. When his self-image gets the best of him, he relies on "Pirin" tablets supplied by his houseboy to calm his nerves and give him so called confidence so he can perform on the stage, and keep the guests coming. Completely clueless to the fact that the "Pirin" tablets are just aspirin tablets with the "A" and "S" scratched off, Albert's "need" for them remains a religious habit.

Albert's surrender to the placebo effect isn't necessarily out of the norm when taking the general population into perspective. Research published in the Journal of Neuroscience surrounding the neurobiological mechanisms of the placebo effect could be used as an excuse as to why people like Albert succumb to pseudo-western medicine prescriptions and expectations to better their condition.

The placebo effect is a psychobiological phenomenon that can be attributable to different mechanisms, including expectation of clinical improvement. In Fabrizio Benedetti's research encompassing this effect, he notes that no matter what medical treatment a patient is receiving, their therapeutic outcome is surrounded by psychosocial contexts. The placebo effect has become a modern topic of interest among scientists and the general public in light of the fact that "we must broaden our conception of the limits of endogenous human capability."

If we can rely on our own homeostatic processes and reduce our usage of unnecessary western medications, some of which have detrimental side effects later in life, we can potentially better our overall well being. In Parkinson's disease research, a pool of patients was given an inert substance (the placebo) and were told that it was an "antiparkinsonian drug that produces an improvement in their motor performance." Results displayed that with their capability to measure endogenous dopamine release, the placebo-induced expectation of motor improvement activates endogenous dopamine in those patients. This ultimately led the patients to better therapeutic outcomes.

We know that the placebo effect is real. Patients involved in thousands of placebo-induced studies have shown a better therapeutic outcome when their expectations and knowledge of recovery is good. Recent uproars are now suggesting the idea of anti-depressant medications being glorified placebos. On account of the pharmaceutical boom for mental illnesses, scientists are heavily researching not only the accuracy of such drugs but the validity.

What does this mean for the Albert's of the world and the rest of us taking conceptually risky medications? Well, even though the thought of people halting their prescription use and relying on their endogenous human capability to run the ship seems amiable, it's not practical. People need medications. However, I definitely think pharmaceutical companies are where the problem lies. How do we know that the neurological drugs that our doctors are telling us we need are in fact necessary or even beneficial for that matter? We don?t. But there's no reason why we shouldn't question the men and women who attended a higher level of education to write us these prescriptions.