Sunday, April 27, 2008

USA Continues Setting Up For Iran Attack

The Clock is Ticking for A US Attack on Iran

By Dave Lindorff
http://www.afterdowningstreet.org/node/33023

I admit to feeling a little like the weatherman who keeps saying it's going to rain, and who eventually is proven correct. I feel certain that the Bush/Cheney regime is going to launch a disastrous attack on Iran, but have made several calls, which have been proved wrong, beginning back in October 2006, when I wrote that it looked like several aircraft carrier battle groups were being put in position for the assault, but then it was called off.

Now it looks like the attack is coming soon.

The Washington Post's Ann Scott Tyson is today reporting in an article headlined, Joint Chiefs Chairman Says US Preparing Military Options Against Iran, that Admiral Michael Mullen, the nation's top military officer, thinks the US military is not stretched too thin to take on Iran, and that Iran is becoming an "increasingly lethal and malign influence" in Iraq.

This article comes only a day after a US civilian ship under contract to the US military to deliver supplies to Iraq fired on Iranian boats in the Persian Gulf--just the kind of aggressive action that could lead to an Iranian reaction and trigger a full-blown US response.

The Persian Gulf is now crammed full of US attack ships, ranging from a missile-armed nuclear sub to aircraft carriers packed with tomahawk cruise missiles and fleets of attack aircraft larger than most nation's entire air forces (and also with nuclear weapons).

Other things also point to an attack, most significantly the pushing out of Adm. William Fallon as Central Command chief, and now his replacement by Gen. David Petraeus, who is widely seen as a "political" general who is essentially a yes-man for Bush and Cheney.

I would say the die is cast, and that it awaits only the pretext.

There would be no melodramatic Congressional debate over the reasons for going to war against yet a third nation this time around. Thanks to the 2001 Authorization for Use of Military Force (AUMF) passed by Congress in October 2001 to authorize the attack on the Taliban and Al Qaeda in Iraq, which Bush and Cheney have illegally and outrageously interpreted as a declaration of a global and unending "War on Terror," the administration is claiming it has the right to attack any nation it defines as "terrorist" at any time, without authorization. Presidential candidate Hillary Clinton helped promote war against Iran a few months ago by backing a Senate resolution authored by Sens. Joe Lieberman and Jon Kyle that defined the Iranian Revolutionary Guard as a "global terrorist" organization. That was all Bush and Cheney needed, as Clinton, Lieberman and Kyle clearly knew.

In what has to be one of the understatements of the century, Adm. Mullen said he knew that conflict would be "extremely stressing" and "distrous on a number of levels."

Indeed it would. Troops in Iraq are already on their fourth and even fifth rotation, and the "surge" troops in Iraq for the past year are being sent home, not because their job of "stabilizing" Baghdad is done (hardly! violence is increasing!), but because there's nobody left to replace them, and they've been there for 15 brutal months.

Worse yet, oil prices have hit a record $122/barrel and are causing a US and even a global recession--but that figure will be doubled the minute any US attack on Iran begins. This is because war with Iran would immediately bring all oil shipments through the Persian Gulf, which supplies 20-25 percent of the world's oil, to a halt. Even if not one tanker were sunk, no insurer would cover a tanker in that region. Moreover, Iranian sappers, and their allies in Iran, Turkey and Saudi Arabia, could be expected to take out vulnerable pipelines, refineries and even well-heads in retaliation to any attack.

So an attack on Iran would mean global economic collapse.

Hold on to your hats. I hope I'm proved wrong yet again, but I'm afraid we're in for a bumpy ride. Even if there is no attack, the level of threats against Iran now emanating from the White House and the Pentagon are sufficient to keep driving oil prices skyward.

Americans should look at those pump prices and see Bush's and Cheney's faces in the digital display.

They should also think of the gas they pump as blood, because it is going to be spilled in prodigious quantities if the US goes through with an attack. Not only would countless innocent Iranians be killed by US bombs and rockets and by any radiation released by attacks on Iran's nuclear facilities (the more so if the US or its Israeli ally use nuclear bombs in that attack), but the toll of US military casualties could be expected to soar, as Iran's Shia allies in Iraq predictably turn on American forces in support of Iran.

Clearly this is all madness, but it is also predictable madness. The Bush/Cheney regime is finishing out its last year as the most disastrous, most unpopular, most loathed presidency in the nation's history, and may even be facing criminal prosecution once out of office. It has approached each election since taking office by upping the military jingoism. I see no reason to see their political strategy changing.

It is critical to them that John McCain and the Republican Party hang onto the White House, and in their view, getting the US into an all-out war with Iran is just the way to do that.

They may be right.
_______________
DAVE LINDORFF is a Philsadelphia-based journalist and columnist. His latest book is "The Case for Impeachment" (St. Martin's Press, 2006 and now available in paperback). His work is available at www.thiscantbehappening.net



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Thursday, April 24, 2008

Healthier Lifestyles Turns Off Disease-provoking Genes And Turns On Good Ones

A short view - the biology of eating better you and you can be better - much better.

If you have not visited the TED website before this is a good introduction to a very useful tool. See more on TED below.
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Dr. Dean Ornish: Your genes are not your fate
At TED2008, Dr. Dean Ornish shares new research that shows how healthy lifestyle habits can affect a person at a genetic level. For instance, he says, when you eat better, exercise, and love more, your brain cells actually increase. And new findings show that a healthier lifestyle can actually turn off disease-provoking genes and turn on the good ones. Watch this talk >>




Dr. Dean Ornish shares new research that shows how adopting healthy lifestyle habits can affect a person at a genetic level. For instance, he says, when you live healthier, eat better, exercise, and love more, your brain cells actually increase. And new findings show that a healthier lifestyle can turn off disease-provoking genes and turn on the good ones.

About Dr. Dean Ornish

Dean Ornish is a clinical professor at UCSF and founder of the Preventive Medicine Research Institute.... Read full bio »




About TED
http://www.ted.com/index.php/pages/view/id/5

TED stands for Technology, Entertainment, Design. It started out (in 1984) as a conference bringing together people from those three worlds. Since then its scope has become ever broader.

The annual conference now brings together the world's most fascinating thinkers and doers, who are challenged to give the talk of their lives (in 18 minutes).

This site makes the best talks and performances from TED available to the public, for free. More than 200 talks from our archive are now available, with more added each week. These videos are released under a Creative Commons license, so they can be freely shared and reposted.

Click here to subscribe to TEDTalks video:

Subscribe2TEDTalks.jpg

Our mission: Spreading ideas.

We believe passionately in the power of ideas to change attitudes, lives and ultimately, the world. So we're building here a clearinghouse that offers free knowledge and inspiration from the world's most inspired thinkers, and also a community of curious souls to engage with ideas and each other. This site, launched April 2007, is an ever-evolving work in progress, and you're an important part of it. Have an idea? We want to hear from you.

The TED Conference, held annually in Long Beach, is still the heart of TED. More than a thousand people now attend -- indeed, the event sells out a year in advance -- and the content has expanded to include science, business, the arts and the global issues facing our world. Over four days, 50 speakers each take an 18-minute slot, and there are many shorter pieces of content, including music, performance and comedy. There are no breakout groups. Everyone shares the same experience. It shouldn't work, but it does. It works because all of knowledge is connected. Every so often it makes sense to emerge from the trenches we dig for a living, and ascend to a 30,000-foot view, where we see, to our astonishment, an intricately interconnected whole.

In recent years, TED has spawned some important extensions.

TEDGlobal is a sister conference held every other year, and in a different country on each occasion. The first conference was held in Oxford, England, in 2005; the second, in June 2007, was held in Arusha, Tanzania. The themes of the global conference are slightly more focused on development issues, but the basic TED format is maintained.

The TED Prize is designed to leverage the TED Community's exceptional array of talent and resources. It is awarded annually to three exceptional individuals who each receive $100,000 and, much more important, the granting of "One Wish to Change the World." After several months of preparation, they unveil their wish at an award ceremony held during the TED Conference. These wishes have led to collaborative initiatives with far-reaching impact.

TEDTalks began as a simple attempt to share what happens at TED with the world. Under the moniker "ideas worth spreading," talks were released online. They rapidly attracted a global audience in the millions. Indeed, the reaction was so enthusiastic that the entire TED website has been reengineered around TEDTalks, with the goal of giving everyone on-demand access to the world's most inspiring voices.

Today, TED is therefore best thought of as a global community. It's a community welcoming people from every discipline and culture who have just two things in common: they seek a deeper understanding of the world, and they hope to turn that understanding into a better future for us all.



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Tuesday, April 22, 2008

SEATTLE TEACHER SUSPENDED FOR REFUSING TO GIVE STANDARDIZED TEST

LOCAL HEROES: SEATTLE TEACHER SUSPENDED FOR REFUSING TO GIVE STANDARDIZED TEST
 
PARENT EMPOWERMENT NETWORK Carl Chew, a 6th grade science teacher at Nathan Eckstein Middle School in the Seattle School District, last week defied federal, state, and district regulations that require teachers to administer the Washington Assessment of Student Learning to students.
 
"I have let my administration know that I will no longer give the WASL to my students. I have done this because of the personal moral and ethical conviction that the WASL is harmful to students, teachers, schools, and families," wrote Chew in an email to national supporters.
 
School District response to Mr. Chew's refusal was immediate. After administrative attempts to dissuade his act of civil disobedience had failed, at the start of school on the first day of WASL testing, April 15, Mr. Chew was escorted from the school by the building principal and a district supervisor. Mr. Chew was told to report to the district Science Materials Center where he was put to work preparing student science kits while district administration and attorneys consulted on an appropriate penalty for what was labeled, "gross insubordination."
 
Mr. Chew attended one hearing at Seattle School District Office, where he was accompanied by a Seattle Education Association representative. On Friday, April 18, Mr. Chew received a letter from Seattle School District Superintendent Maria Goodloe-Johnson which began, "This letter is to inform you that I have determined that there is probable cause to suspend you from April 21, 2008 through May 2, 2008 without pay for your refusal and insubordination to your principal's written direction to administer the WASL at Eckstein Middle School."
 
During his weeklong struggle with the district over consequences, Mr. Chew was supported by allies throughout the state and nation. "Carl Chew is saying 'No!' to high stakes testing and a resounding 'Yes!' to student needs and to teacher professionalism," stated nationally renowned education activist and author Susan Ohanian of Vermont.
 
"There are many more teachers who are ready to follow suit. They just need an example and leader," states one Washington teacher.
 
Organizations and individual allies are now working to replace Mr. Chew's lost wages. "Though a minor gesture in response to your so much larger gift, I plan to contribute to your salary for the two-weeks the schools aren't paying," was the response of one colleague from Washington.
 
CARL CHEW On April 15 I refused to give the Washington Assessment of Student Learning to my 6th grade students at a Seattle Public Schools middle school. I performed this single act of civil disobedience based on personal moral and ethical grounds, as well as professional duty. I believe that the WASL is destructive to our children, teachers, schools, and parents.
 
It is important for me to note that my disobedient action was not directed at any individual. I love being a teacher; my students are fantastic; my fellow teachers collaborate with and help me every day in numerous ways; and my school administration has always shown a willingness to listen to and support the teachers. I understand that my action has caused people pain, and I am truly sorry for that, but I could no longer stand idly by as something as wrong as the WASL is perpetrated on our children year after year. . .
 
To my mind the measure of successful childhood is that each child learns about who she or he is and how the world works, gains an assertive and confident self image, and feels safe, well fed, and happy. Schools, along with parents and communities, need to contribute wisely to this goal. Unfortunately, the WASL creates panic, insecurity, low self esteem, and sadness for our children.
 
o It is written in the language of white, middle and upper class students, leaving all others behind.
 
o It is presented to children in a secretive, cold, sterile, and inhumane fashion.
 
o There is no middle ground--children either pass or fail--which leaves them confused, guilty, and frustrated.
 
o Numerous questions on the test are unclear, misleading, or lacking in creativity.
 
o It tests a very narrow definition of what educators know children need to become well-rounded human beings.
 
o The WASL is given at a prescribed time regardless of a child's emotional or physical health.
 
o A majority of teachers loath the WASL but feel unable to speak out freely against it due to their fears of negative consequences for doing so.
 
o Because administrators are constantly pushing to meet federal guidelines for yearly score improvements, their relationships with teachers can become strained and unpleasant.
 
o Administrators and teachers suffer under the knowledge that if they do not achieve improvement goals (measured by WASL passage alone) they can be sent to retraining classes, lose their students to other schools, or have their "failing" school handed over to a private company.
 
o Before administering the WASL teachers mandatorily sign a "loyalty" oath promising they will not read any of the test questions.
 
o Teachers feel devalued by the amount of time most of them have to devote to test practice and proctoring--upwards of four weeks for actual testing and many more weeks for WASL prep in many cases.
 
o Teachers feel used and depressed when, half a year after the test is given, they are presented with dubious WASL results--amateurish and misleading Power Point charts and graphs telling them next to nothing about their students' real knowledge and talents.
 
o Teachers' relationships with parents are compromised because they cannot talk freely with them about opting their child out or other WASL concerns.
 
o Parents have been shut out of this costly process.
 
o Most of them are misled by official statements about what the purpose of the WASL is.
 
o Many of them do not realize that they have the right to opt their children out of testing with no consequences, though in practice schools have illegally put inappropriate pressure on parents and children who have opted out.
 
o Many of them do not realize that teachers are, in many cases, not allowed to discuss any reasons why they might want to opt their child out. (Teachers in California went to court to secure the right to inform parents of their right to opt their children out of that state's testing.)
 
o Like children, parents suffer from the same feelings of guilt and unhappiness when their children fail.
 
o Parents are not informed that the test is biased, culturally insensitive and irrelevant, and not a real measure of anything.
 
o The WASL graduation requirement has kept thousands of families from knowing whether or not their students will be allowed to take part in graduation ceremonies and celebrations--the culminating reward for 13 years of public school attendance and achievement-- with friends and families.
 
o While schools are generally underfunded, Washington will spend a projected $56 million in 2009 to have a private corporation grade WASL tests. These tax dollars are needed right in our schools providing more teachers, smaller classes, tutors, and diverse educational experiences for our students.
 
o While the federal government requires that school districts use high stakes testing to qualify for federal dollars, tests are not fully funded by the federal government.
 
o WASL is one of the most difficult tests used to fulfill the federal requirements, with one of the highest failure rates.
 
o Instead of safe, exciting, and meaningful places for our children to spend half of their waking hours, schools have become WASL or test mills bent on churning out students who are trained to answer state-approved questions in a state-approved manner.
 
o Most, if not all, teachers will agree that assessment is vital. Wise teachers know that assessments which are also learning experiences for students and teachers are the best. The WASL categorically is not a learning experience.
 
o I believe that individual students are entitled to their own learning plans, tailored to their own needs, strengths, and interests. Teachers know it is definitely possible to do this in the context of a public school. The WASL categorically treats all children alike and requires that they each fit into the same precise mold, and state-mandated learning plans based on WASL scores fail to recognize individual strengths of students.
 
o Passing the WASL does not guarantee success in college, placement in a job, a living wage, or adequate health care.
 
o WASL will decrease the high school graduation rate. Thousands of students who have completed all other requirements and passed all required classes will be denied diplomas because of WASL failure.
 
o High-stakes testing has not proven beneficial to students, teachers, schools, or communities.
 
o When I was a teacher at Graham Hill Elementary in Seattle, a number of my students received their WASL scores to find that they had "failed". When I looked at the notices being sent to their parents I saw that each student had come to within just a few points of actually passing and that their scores were well within the grey area, or "margin of error," for the test. The "test scientists" aren't sure whether the student passed or failed, yet the school tells the student he or she failed. These students cried when they saw the results.
 
o When I first started teaching, Graham Hill could afford Americorps tutors, numerous classroom aides, and had money for fieldtrip buses and ample supplies. By the time I stopped teaching there, Americorps was gone, there were no classroom aides except for parent volunteers, and everything else was in short supply. . .
 
o No one ever asked me or any of the teachers I know whether high stakes testing was a good idea. In fact, we teachers are made to jump through seemingly endless hoops to prove our worthiness to be professional, certificated educators. Public school teachers are responsible for the educational lives of over a million students in Washington State, yet, in the end, no one actually wants to listen to what teachers have to say about what is best for the students in our care.
 

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Monday, April 21, 2008

'Secret' New Orleans 3 Day Bush-o-nomics To Expand NAFTA For Chinese Goods & More

José Can You See?  Bush’s Trojan Taco

By Greg Palast

Monday April 21, 2008

(for TomPaine.com)

Psst!  George Bush has a secret.  

While you Democrats are pounding each other to a pulp in Pennsylvania, the President has snuck back down to New Orleans for a meeting of the NAFTA Three:  the Prime Minister of Canada and the President of Mexico.

You’re not supposed to know that – for two reasons:  

First, the summit planned for the N.O. two years back was meant to showcase the rebuilt Big Easy, a monument to can-do Bush-o-nomics.  Well, it is a monument to Bush’s leadership:  The city still looks like Dresden 1946, with over half the original residents living in toxic trailers or wandering lost and broke in America.
 
The second reason Bush has kept this major summit a virtual secret is its real agenda.   More important, the agenda-makers, the guys who called the meeting, must remain as far out of camera range as possible:  The North American Competitiveness Council.  

Never heard of The Council?  Well, maybe you’ve heard of the counselors:  the chief executives of Wal-Mart, Chevron Oil, Lockheed-Martin and 27 other multinational masters of the corporate universe.  

And why did the landlords of our continent order our presidents to a three-nation pajama party?  Their term is “harmonization.”

Harmonization has nothing to do with singing in fifths like Simon and Garfunkel.  Harmonization means making rules and regulations the same in all three countries.  Or, more specifically, watering down rules – on health, safety, labor rights, oil drilling, polluting and so on - in other words, any regulations that get between The Council members and their profits.

Take for example, pesticides.   Wal-Mart and agri-business don’t want to reduce the legal amount of poison allowed in what you eat.  Solution:  “harmonize” US and Canadian pesticide standards to Mexico’s.  

Can they do that?  Can Bush just say, “Eat your peas – even if they’re radioactive?”  Under NAFTA, at least the way George Bush reads it (or has it read to him), he can.  At any rate, he does.

The three chiefs of state will meet privately with the thirty corporate chiefs where they are also expected to legally erase more of our borders, to expand the “NAFTA highway.”  Technically, the NAFTA highway is a set of legal rules governing transcontinental shipment.  Some fear NAFTA highway expansion will allow a new flood of cheap Mexican products into the US and Canada.  Not so. 

Their hunger to expand the NAFTA highway is to bring in even cheaper Chinese goods.
 
Say what?

As trade expert Maud Barlow explained to me, the new “NAFTA highway” will allow Chinese stuff dumped into Mexico to be hauled northward as duty-free “Mexican” products. 

That’s one of the quiet agendas of this “Summit for Security and Prosperity,” the official Orwellian name for this meet.  Think of the SSP “harmonization” as the Trojan Taco of trade.

Barlow is Chairwoman of the Council of Canadians.  She is known as the “Ralph Nader of Canada” (not Nader version 2.0, The Spoiler Candidate, but Nader version 1.0, the consumer advocate).  Because Americans are too distracted by the Punch-and-Judy primaries to complain about this lobby-fest on the bayou, Canadian Barlow is leading street protests against this greed-grab.   

I caught up with this courageous Canadian (I’ve seen her face down corporate bullying we can’t imagine in the US) on her way down to New Orleans.  Barlow’s particular concerns are first, the NSS agreement promotes a five-fold increase in the mining of Canadian tar sands for import, as liquid crude oil, into the USA, an idea filthier than a re-make of  Debbie Does Dallas.  “This is an insane model of development,” she says, especially given Bush’s recent claim that he wants to slow global warming.   

Bush himself is pushing his Canadian and Mexican counterparts to adopt US-style “Homeland Security” measures so that, says Barlow, “we’ll all be zip-locked together in one security bag.”

There will be other anti-SSP protesters in New Orleans as well, from America’s populist Right.  They are concerned that the Security and Prosperity Summit is worse than the “NAFTA on steroids” that Barlow fears.  The populists see in the SPP a nascent “North American Union,” and the elimination of the good old US of A.
 
They’re wrong, of course.  The U.S. of A. has been long eliminated, at least economically.  The Competitiveness Council is a multinational crew, with one shared set of country clubs, beach homes, art collections, union busters and lobbyists knowing no borders.   

The populist radio hosts railing against the coming North American Union don’t realize that these CEOs won’t take away their flags or Fourth of July or Star-Spangled Banner.  The rags and flags will always be kept around to con the schmucks along the Yahoo Belt into donating their children to the Iraq Occupation or other misadventures.  A billionaire like Carlos Slim, the richest man on the planet (sorry, Mr. Gates), didn’t buy the Mexican government to “protect” his nation from Gringos but to protect his media monopoly.  

So there is no United States of America nor Canada nor Mexico - at least as we like to imagine ourselves in our national fairy tales:  self-governing democracies run by we the people or nosotros el pueblo.  There’s just the diktats of the North American Prosperity Council.  Get used to it.

Barlow said that the US Ambassador to Canada told her the legal changes wrought in New Orleans will not be put before the three national Congresses for a vote. 

“We don’t want to open up another NAFTA.”  So, they’ll skip the voting stuff.  Democracy is so, like, 20th Century.

Is Bush just a reluctant participant in this “harmonizing” of our economic fate?  The meetings are secret, so I can’t say for sure.  But I note that, at the opening ceremony, if you read his lips, you can see our president singing the national anthem as, “José, can you see?”

***********
Greg Palast is the author of the New York Times bestsellers, The Best Democracy Money Can Buy and Armed Madhouse:  Sordid Secrets and Strange Tales of a White House Gone Wild.   Sign up for Palast’s investigative reports for BBC on RSS feed at http://feeds.feedburner.com/gregpalast-articles

Make a donation to the not-for-profit Palast Investigative Fund and receive a DVD of  the untold story of the drowning of New Orleans, Big Easy to Big Empty, made for Democracy Now! at http://www.PalastInvestigativeFund.org
 
Note:  On May 1, in New York, Palast will speak at the international conference of the victims of Barrick Gold mining operations, the Canadian-American company whose board members included the former Prime Minister of Canada Brian Mulroney and the former President of the United States, George Bush Sr.  Information soon at www.GregPalast.com

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Caffeine: Psychological Effects, Use and Abuse

Caffeine: Psychological Effects, Use and Abuse

Sanford Bolton, Ph.D. and Gary Null, M.S.

Note: The information on this website is not a substitute for
diagnosis and treatment by a qualified, licensed professional.
http://garynull.com/articles/Caffeine_April.19.08.doc


ABSTRACT

Caffeine, probably the most widely used drug, affects the psychological
state of those who consume it. Abuse results in symptoms of caffeinism
which include agitation, disorientation and a syndrome which may be
mistaken for anxiety/neurosis. It is a habit-forming drug in which
tolerance develops. It affects sleep in a dose related manner which is
dependent on the daily caffeine intake, i.e., high users have less
effect. Its central nervous system stimulation can cause pleasant
effects with improved attention and concentration at lower doses. At
high doses, the reverse may occur. Used judiciously, it may be a useful
therapy in the treatment of hyperkinetic children. These and other
effects of caffeine are discussed in this review article.

INTRODUCTION

Caffeine is among the most widely used drugs because of its ubiquitous
occurrence in commonly consumed beverages such as coffee, tea and cola.
Many drugs contain caffeine and are readily accessible to the public in
the form of OTC stimulants and combination analgesics. Clearly caffeine
is an important drug-food substance in our society which deserves
attention. According to an in depth 1999 article in Pharmacological
Review which discusses the ways that caffeine affect our neural biology,
on average, people drink between 70-76 mg of caffeine a day, between
210-238 mg in North America, and about double that in the Netherlands .

To begin to have a new consciousness about caffeine so that we can
become aware of how this drug can affect our physiology and psychology
is a problem. The reasons for this are certainly complicated, but we can
start by considering a factor dominating all of our lives, our "habits."
When we become aware of and take responsibility to change habits, we are
taking a first step in the process of awakening. The result must be not
only an improvement in the quality of our lives but the world itself
will be changed for the better.

The use and abuse of caffeine is a major public "habit' and may be as
important a factor as heredity and environment in the etiology of
physiological and psychological disorders. To recognize this, we must
know that we are creatures of habit. Most people are caffeine consumers
because from birth this food-drug is set before us, if not offered
directly, along with orange juice, cereal, dessert and cigarettes.

This paper reviews the literature relating to the psychological effects
of caffeine. Caffeine is a potent central nervous system stimulant and
much of its "psychological" activity may be related to this action of
the drug. Its effects on the nervous system are obviously adverse at
high doses. It may not be obvious that at lower doses when used in
moderation, it may have beneficial effects. For example, its possible
therapeutic use in hyperkinetic children certainly would seem
advantageous when compared to the current treatment with more powerful
stimulants which have concomitant adverse reactions. Also, with the
intense day to day pressures imposed on and accepted by many of us, is
there any harm in "relaxing" with a hot cup of coffee? On the other
hand, caffeine is a drug which is subject to abuse. The fact that it is
a drug with a potentially powerful physiological effect escapes most of
us who think of coffee as a relatively harmless beverage. Recently
published studies and reports of personal observations have shown
without doubt that caffeine abuse (caffeinism) may result in a syndrome
which resembles and may be confused or confounded with true psychotic
states. This may lead to misdiagnosis and mistreatment. A question
arises from the varied reports of caffeine consumption in psychiatric
populations: Does caffeine stimulate psychosis or does psychosis
stimulate caffeine consumption?

These are not trivial findings because of the ready availability of
caffeine and the epidemic of psychological problems which we are
experiencing in this era. This report reviews some of the knowledge of
caffeine's effects with the hope that we will all be more educated and
more careful in the use of this commonly ingested drug.

The physiological action of caffeine is briefly reviewed, as
psychological and physiological effects must go hand-in-hand. In
addition to its central nervous system effects, caffeine has significant
effects on the cardiovascular system, gastric acid secretion and
catecholamine (adrenaline) release. In large doses, it has been shown to
be a mutagen in animals, plants and bacteria, and has been shown to
exhibit teratogenic properties in various animal species.

PHYSIOLOGICAL AND PHARMACOLOGICAL EFFECTS

J. Murdoch Ritchie, in Goodman and Gilman's Pharmacology Text (Ritchie,
1975) described the pharmacological effects of caffeine. The largest
sources of caffeine are from the plants used to make coffee, tea, cocoa
and kola (the basis of cola beverages), although it is also found in
Latin America as mate' and guarana. Caffeine particularly has a profound
effect on the central nervous system, but it also affects, to a lesser
degree the heart muscle, gastric secretion and diuresis. Interestingly,
caffeine is ingested daily by a vast number of people and is unique in
that it is a potent drug, considered to be part of our normal diet.

Caffeine stimulates the central nervous system first at the higher
levels, the cortex and medulla, and finally the spinal cord at higher
doses. Mild cortex stimulation appears to be beneficial resulting in
more clear thinking and less fatigue. Caffeine has been shown to improve
attention in a study which simulated night driving (Leinart, 1966). The
onset of the effect of caffeine occurs within one hour and lasts for
three to four hours (Baker, 1972).

The equivalent of one or two cups of coffee (150 to 250 mg of caffeine)
is sufficient to induce adverse effects. The occurrence of
hyperesthesia, an unpleasant sensory sensation, can be stimulated by
large doses of caffeine.

The medullary, respiratory, vasomotor and vagal centers are stimulated
by caffeine. This effect is due to an increased sensitization to carbon
dioxide but needs large doses to elicit this effect, 150 to 250 mg,
parenterally. The spinal cord is stimulated at higher doses and
convulsions and death may result. More than 10 g are needed for such
toxicity to occur in man (Ritchie, 1975).

Stimulation of the CNS is followed by depression (Klein and Salzman,
1975), although the effect is small at low doses e.g. a single cup of
coffee. After two hours, Klein reported that males (but not females)
showed a lower CNS stimulation compared to placebo. The post stimulation
"let down" with caffeine results in fatigue and lethargy and the
constant stimulation caused by chronic caffeine dosing could be
disastrous (Abrams, 1977; Dowell, 1965).

Children, because of their smaller size, are more susceptible to
caffeine. One report noted that hyperactivity and insomnia observed in
children could be attributed to excess caffeine intake from cola drinks
(Consumer Research, 1973). According to Dr. Page, "There is no doubt
that children should be kept from using coffee and the popular caffeine
containing soft drinks." (Abrams, 1977).

Caffeine's effect on the cardiovascular system predominates at very
large doses with rapid heart rate and, eventually, irregular heart beats
result. For example, a Middlesex, UK hospital discusses a 2007 case
study of a person who had swelling of the heart muscle due to too much
caffeine in the diet. The report noted that after half a year of
abstaining from caffeine, the symptoms went away. The authors of the
article mention that this case study could have relevance to the wider
population, because in a portion of people who have irregular heart beat
also have inflamed heart muscle that make beating of the heart
difficult, which is caused by rapid beating of the heart. This has
relevance to those who drink too much caffeine . Caffeine seems to have
a non-discrimminatory effect on the cardiovascular system: in a 1983
study in the journal Psychosomatic Medicine, an experiment shoed that in
young men, even non-extreme caffeine intake raised blood pressure both
during periods of stillness and during times of bodily demand .

Adenosine receptors may be the mechanism through which caffeine works in
the heart. Adenosine receptors are found throughout the body, and tend
to depress the function of that particular organ. For example, in the
brain adenosine slows bodily functions by manipulating the speed at
which various neurons fire. In the heart, adenosine works by slowing the
heart-beat, by affecting the neural pathways that stimulate the pacemaker .

This is one of the reasons for many of the recent studies on caffeine
and its relevance to heart functioning--caffeine and various its
immediate byproducts such as —theophilline – act against those adenosine
receptors and, as a result speed up neuronal firing.

A 2002 rodent study confirmed the involvement of adenosine receptors in
cardiac conditions --by the use of drugs which blocked specific receptor
action—and showed that animals given caffeine laced water had a faster
heart beat and elevated blood pressure as compared to non-caffeinated
animals .

Recently, a whole field of science for Parkinson's sufferers has opened
up on the use of adenosine blockers—called 'adenosine antagonists .'
Coffee, by action of its caffeine content, is an adenosine antagonist,
and we will look at some of its effects:

Therapeutic effects have been suggested for caffeine because it inhibits
the "freezing of gait" difficulties of advanced Parkinson's sufferers
for a short period of time. In one study however the patients regained a
tolerance to caffeine, and the effect disappeared until the patient
stopped the use of caffeine for a time . In fact, many studies have
examined the link between low incidence of Parkinson's and coffee
drinking, and low incidence of Parkinson's and cigarette smoking:

Neuroepidemiology. 2003 Sep-Oct;22(5):297-304. Links

A case-control study on cigarette, alcohol, and coffee consumption
preceding Parkinson's disease. "results suggest an inverse association
between coffee drinking, alcohol consumption and PD."

Neurology. 2001 Apr 10;56(7):984-5.

Smoking, alcohol, and coffee consumption preceding Parkinson's disease:
a case-control study. "These findings suggest an inverse association
between coffee drinking and PD; however, this association does not imply
that coffee has a direct protective effect against PD. Alternative
explanations for the association should be considered"

Please note, however, that the authors of the article in Neurology above
do not say that the inverse relationship found between the activity of
coffee drinking and Parkinson's disease means that the activity of
coffee drinking or cigarette smoking prevents Parkinson's. It says that
further study of the relationship is warranted.

Although we know that caffeine is directly an adenosine antagonist, it
also increases nerve cell firing.

1) "Caffeine acts as a competitive antagonist to the inhibitory effects
of adenosine… One of these effects is to increase the release of the
excitatory neurotransmitters serotonin and noradrenaline." Journal of
Physiology (2002), 545.2, pp. 671-679 Effect of caffeine on
self-sustained firing in human motor units University, Toronto, ON, Canada

2)2001 Elsevier Science B.V. All rights reserved.

Caffeine increases paragigantocellularis neuronal firing rate and
induces withdrawal signs in morphine-dependent rats

3) "caffeine increased spontaneous firing of neurons between 12 and 80
min after treatment" Caffeine Regulates Neuronal Expression of the
Dopamine 2 Receptor Gene The Neurosciences Institute, San Diego,
California accepted August 19, 2003

Excess firing of neurons is suggestive of brain damage in human and
animals as well:

1)"Caffeine has been used clinically to increase seizure length in
electroconvulsive treatment (ECT)"Caffeine augmentation of
electroconvulsive seizures Journal Psychopharmacology 8 December 1993
University, Toronto, ON, Canada

2) "Caffeine adversely affects outcome after concussive head injury,
possibly as a result of blockade of adenosine receptors." Caffeine
Impairs Short-term Neurological Outcome after Concussive Head Injury in
Rats. Neurosurgery. 53(3):704-712, September 2003.

3)Is Caffeine an Effective Pesticide Against Drosophila (fruit fly)?
Science project at PJAS Region 1B, first at PJAS States, second at
Montgomery County Science Research Competition, and third at Delaware
Valley Science Research Competition. "The overactive nervous system
placed an extremely heavy emphasis on the gravitational stimuli, an
emphasis so extreme that the flies suffocated themselves in the foam
stoppers while responding to it."

And, finally, in layman's English:

"The average consumer may unwittingly consume excessive amounts of
caffeine that may lead to adverse physiological side effects."Is
Caffeine Excess Part of Your Differential Diagnosis?. Nurse
Practitioner. 29(4):39-44, April 2004.
Bridle, Leisa RN; Remick, June BSN, RN; Duffy, Evelyn MS, RN, CS

Caffeine studies on various areas of the body, including bone and sperm
show that caffeine causes oxidative stress . Caffeine has been shown to
kill rodent brain cells in laboratory studies. Cell cultures of outer
brain cells were killed at concentrations of 300 Molar of caffeine.
Initial living animal studies have begun to show toxic effects of
caffeine at very high doses. In newborn rodents, concentrations of 50
mg/kg of caffeine killed brain cells in assorted areas of the brain.
This, of course, is a lot of caffeine. (For a person weighing 154
pounds, this comes out to 3500 mg of caffeine 3x per day)

Conversely, however, a study on the preventive use of caffeine on the
blood vasculature is underwhelming: This experiment, published in the
American Journal of Clinical Nutrition in 2007, showed that those who
drank liquids containing caffeine, had a smaller likelihood of
cardiovascular illness and death only if they did not have extreme
levels of high blood pressure to begin with. Additionally this caffeine
consumption did not protect those who were younger than 65, nor did it
prevent death related to blood vessel disease in the brain . Since
American caffeine consumption comes, for the most part, through drinking
coffee, physician Joe Vinson suggests that it may be a causal factor in
the development of high blood pressure to begin with.

In addition to the conflicting information on the cardiovascular system
and brain, seemingly condradictive data has been found between drinking
coffee and diabetes. Apparently, studies since the year 2000 showed that
caffeine increased blood glucose levels after eating. However, a large
review showed that drinking coffee was related to a lower risk of
developing diabetes type 2 .

Bodily levels of magnesium may have something to do with the risk of
developing diabetes : A 1999 Netherlands study notes the inclination of
diabetes type 2 sufferers to be lacking in magnesium and that magnesium
given supplementally increases the body's ability to process blood
glucose . Data has also shown that coffee leaches magnesium from the
body. A 1994 study entitled, "Effect of caffeine on circadian excretion
of urinary calcium and magnesium," showed that the kidney was not able
to overcompensate for mineral loss due to caffeine consumption early in
the day, and that net losses of calcium and magnesium occurred by the
evening. .

The clinical literature is also starting to show that we can create
environmentally low levels of essential minerals in our bodies through
what we consume: There are now numerous studies starting to show that
caffeine consumption is related to the leaching essential minerals from
the body. For example,

A 1993 Journal of Nutrition article states that the intake of
caffeinated beverages raises the level of mineral elimination of the
body for a minimum of one eighth of the day after caffeine intake. The
article further notes that elderly females do not have enough dietary
intake of minerals to compensate for the loss due to caffeine. .

A 2007 study on the effects of dietary caffeine on the risk of
developing diabetes showed that blood magnesium levels were lower in
those who consumed dietary caffeine, versus those who did not .

Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake
increases the rate of bone loss in elderly women and interacts with
vitamin D receptor genotypes. Am J Clin Nutr 2001;74; 694–700.

A study published in the Journal of the American College of Nutrition
shows that caffeine consumption had a negative association with bone
mineral density in women throughout the body when a person consumed
200-300 mg/day of caffeine .

We also have examples from the literature examining the possible links
between nutrient depletion and neurological illness:

Mechanisms of Action on the Nervous System in Magnesium Deficiency and
Dementia Magnes Res. 1997 Dec;10(4):339-53.

Are age-related neurodegenerative diseases linked with various types of
magnesium depletion?
Durlach J, Bac P, Durlach V, Durlach A, Bara M, Guiet-Bara A.

Caffeine also seems to have a direct effect independent of those we
already mentioned) on certain tissues within the body:

An interesting 2007 animal study done at the University of Massachusetts
Medical School shows that caffeine and its byproducts affect heart
cells, independent of other mechanisms and that that irregular heart
beat may be related to activation of a specific ion channel by caffeine
and its biochemical products .

Although caffeine dilates blood vessels by a direct action, its central
effect is one of constriction. At higher doses, the dilating effect is
apparent (Peach, 1972; Poisner, 1973).

Similarly, because its direct and central effects are antagonistic, the
resultant effect of caffeine on blood pressure is unpredictable. The net
effect is usually of less than 10 mm of Hg in blood pressure (Ritchie et
al., 1975). Caffeine's purported efficacy in hypertensive headaches may
be due to a decrease in blood flow as a result of the increased cerebral
resistance (Ritchie et al., 1975).

Caffeine also stimulates releases of catecholamines from the adrenal
medulla and norepinephrine is released from nerve endings in the
isolated heart (Bellett et al., 1971). .

It has been shown that prolonged augmentation of gastric 'secretion
results from caffeine administration and that ulcer patients have
sustained elevation of acid as opposed to normals (Ritchie et al., 1975).

Although a dose of approximately 10 g or more taken orally can be fatal,
an oral (3.2 g IV) one gram dose will cause adverse effects (Gleason et
al., 1969). The toxic effects are due to CNS and circulatory system
stimulation and include some well recognized prominent symptoms in
addition to those which can result at high doses or in hypersensitive
persons: insomnia, restlessness, excitement, tinnitus, flashes of light,
quivering muscles, tachycardia, extrasystoles, and even low grade fever
and mild delirium have been observed.

Harrie (1970) described a patient whose constant headaches were due to
excessive caffeine consumption. He states, "I suspect that the condition
is much more common than supposed and could well be one of the more
frequent causes of chronic recurrent headache." Headaches can also be
precipitated by caffeine withdrawal especially by those who have the
"habit".

Although caffeine is well absorbed when taken orally, its absorption may
be erratic because of its low solubility and because it may cause
gastric irritation. Caffeine is principally metabolized with only 10
percent excreted in the urine unchanged (Ritchie et al., 1975).

Caffeine has a physiological half-life of three and a half hours
(Parsons and Neims, 1978) to six hours (Aranda et al., 1979). Its
physiological effects are observed in less than one hour (Parsons and
Neims, 1978). Infants do not metabolize caffeine as well as adults and
thus have a half-life of about four days (Aranda et al., 1975).
Certainly, continuous ingestion of caffeine by infants can be dangerous.
If a cup of coffee is consumed by an adult six or seven times a day it
would result in a high steady concentration of caffeine in the blood. As
little as four cups a day can result in appreciable omnipresent amounts
of caffeine in the body.

Caffeine can accumulate in severe liver disease (Stratland, 1976) when
its half-life can increase to 96 hours. If these patients drink coffe(~
they should be closely monitored.

Caffeine is known to interact with other drugs resulting in a modified
effect. For example, caffeine administered with nardil (an MAO
inhibitor) caused headaches and high blood pressure (Pakes, 1979). This
potentially dangerous interaction was first noted by Berkowitz et al.,
(1971) and implicated serotonin in the mechanism.

Caffeine and barbitol are antagonistic, with caffeine (in coffee)
reducing the sleeping time induced by barbitol. Decaffeinated coffee had
no effect (Aeschbacher et al., 1975). In another study, caffeine
resulted in reduced sleeping time which was counteracted by
pentobarbitol in hospitalized patients (Forrest et al., 1972).

PSYCHOLOGICAL EFFECTS OF CAFFEINE

Because of the wide spread use of caffeine and its known potent
physiological effects, caffeine has been the subject of research in
psychological related studies. This work has been stimulated by personal
experiences and observations as well as by efforts to understand its
action and mechanism.

Habituation and Tolerance: Caffeine ingestion and coffee drinking have
been investigated with regard to the degree that this habit results in
tolerance and withdrawal effects. These studies look beyond the obvious
social implications and psychic dependence (Ritchie et al., 1975) of
coffee consumption which may be related to the "first cup of coffee to
wake me up" or "the coffee break" or to its association with smoking. In
the latter case, it is of interest that coffee drinkers were shown to
take more nicotine when deprived of coffee (Kozlowski, 1976).

Caffeine has not only been considered habit forming, but also addicting.
Crothers considered morphinism and caffeinism to be similar, with
caffeine causing loss of self-control, spells of agitation and
depression as well as psychotic behavior (Stephenson, 1977). Ritchie
mentions a report by Colton that tolerance can develop for the diuretic,
salivary stimulation and sleep disturbance effects of caffeine.

Cola consumed in amounts of 48 to 111 ounces per day (144 to 333 mg of
caffeine per day) was reported to have caused physical effects on
withdrawal (Diamond and Pfifferling, 1974). The resultant effects were
depression, nervousness, decreased alertness, sleeping difficulty,
frequent mood changes, and various other behavioral difficulties which
were attributed to caffeine withdrawal.

The dependence of coffee drinkers on caffeine was illustrated in a study
by Kozlowski (1976) in which coffee drinkers drank more coffee if the
caffeine content was lowered.

Abrams (1977) says "There is no doubt that a certain degree of psychic
dependence, that is habituation, develops from the use of xanthine
beverages".

A questionnaire completed by more than 200 young housewives showed that
the perceived effects of caffeine depended on previous use (Goldstein et
al., 1969). The heavy coffee drinkers had few sleep disturbances and
less evidence of nervousness after their morning coffee as compared to
nondrinkers. if the morning coffee was stopped, the habitual coffee
drinkers experienced nervousness, headache and irritation. The
non-coffee drinkers reacted negatively to coffee, experiencing effects
opposite to the coffee drinkers. An experiment was devised to verify the
results of the questionnaire involving 18 housewives, non-coffee
drinkers, and 38 who drank five or more cups per day. The results
confirmed those obtained from the questionnaire previously administered
(Goldstein et al., 1969). This experiment was double-blind and placebo
controlled and caffeine was administered in coffee at 0, 150 and 300 mg.
Coffee drinkers showed a dose-response effect whereas non-coffee
drinkers showed signs such as nervousness, jitters and upset stomachs at
all doses of caffeine but not on placebo.

Ritchie (1975) says that tolerance and psychological dependence to
caffeine beverages does occur to some extent but he feels that this
does-not present a problem. He says that coffee or tea drinking are
socially acceptable and are apparently not harmful when practiced in
moderation.

However, it does appear that at least in some persons excess consumption
of caffeine can result in severe phychological dependence and withdrawal
effects and is a problem to be reckoned with.

Behavioral Effects: Caffeine's stimulating activity on the central
nervous system as well as other body organs results in certain
physiological effects which may be considered to be behavior oriented.
Caffeine produces more rapid, clearer flow of thought, allays drowsiness
and fatigue, increases the capability of a greater sustained
intellectual effort and more perfect association of ideas. It also
causes a keener appreciation of sensory stimuli, and reaction time is
diminished. Motor activity is increased; typists, for example, work
faster with fewer errors. Tasks requiring delicate muscular cobrdination
and accurate timing may, however, be adversely affected. All of this
occurs at doses of 150 to 250 mg of caffeine (approximately two cups of
coffee) according to Ritchie (1975).

In 1912, Hollingsworth who was a psychologist reported caffeine's effect
on mental and motor efficiency in a study sponsored by Coca-Cola. In
nine double-blind tests, he found beneficial effects for both mental and
motor performance at doses of 65 to 130 mg of caffeine. At a dose of 300
mg, caffeine caused tremors, poor motor performance and insomnia. These
results have withstood the test of time (Stephenson, 1977).

Goldstein (1965) showed no effect of caffeine on objective measures of
performance although most subjects "felt" more alert and physically
active. However, some subjects felt nervous.

Mitchell, Ross and Hurst showed caffeine to prevent attention lapses in
a visual monitoring test which simulated night driving. The effect
persisted for the two to three hour experiment (Stephenson, 1977).

A 200 mg dose of caffeine resulted in decreased decision time scores and
improved motor time scores in volunteers (Smith et al., 1977). Hand
steadiness, however, was impaired. After a caffeine intake of 200 mg,
introverts performed less well on a verbal ability test as compared to
extroverts when time pressure was applied (Ritchie et al., 1975).

Wayner et al. (1976) reported on the effects of caffeine on schedule
dependent'and schedule induced behavior in mice. Caffeine, (3.125, 6.25,
12.5, 25, 50 and 100 mg/kg) was tested on lever pressing, schedule
induced licking and water consumption of mice. The effect on mice at 80
percent of body weight was different than when mice were allowed to
recover the lost weight. At the lower weight, caffeine had little effect
except at the highest dose (equivalent to 100 cups of coffee given at
once). At their ordinary weight, the mice were more sensitive to
caffeine, with all measures enhanced, even at the lowest dose
(equivalent to approximately three cups of coffee). At high doses, all
measures decreased; the mice became tolerant.

Castellano (1976) studied mice behavior under two sets of conditions.
One involved a natural preference (swimming towards a light-"L" ) and
the other involved an acquired behavior pattern (swimming toward the
dark-"D"). A facilitation of learning and consolidation after caffeine
dosing was noted in naive mice after the -D" procedure. Natural
tendencies were also enhanced by caffeine as noted by improved
performance in the "L" procedure. Animals pretrained in the "D"
procedure exhibited behavioral disruption after treatment. Animals
pretrained in the natural -U procedure needed very high doses to cause
disruption. Caffeine decreases five HT turnover in rat brain.
Amphetamines do not show the results as demonstrated in this paper,
whereas other drugs such as hallucinogens show a similar effect. The
implication is that the mechanism of caffeine's action may be similar to
hallucinogenic drugs.

Effect on Sleep: Caffeine is known to cause insomnia because of its
central nervous system stimulating activity. In fact, its major
therapeutic use is to allay sleep and drowsiness, being the only OTC
stimulant approved by the FDA. Several studies investigating this action
in some detail have been published.

Karacan (1976) found that caffeine given half an hour before sleep
adversely affected the sleeping process in normal sublects. The effect
is dose related. Caffeine's effect simulates clinical insomnia and gave
the same response as coffee containing an equivalent amount of caffeine.
Decaffeinated coffee showed no effect on sleep.

Dorfman and Jarvick (1970) showed a dose-response effect of caffeine on
the self estimation of sleep latency (which was increased) and quality
(which was decreased). This was a double-blind study in which 0, 60,
120, and 250 mg of caffeine was administered one hour before bedtime.

Mikkelsen (1978) notes that caffeine seems to inhibit deeper stages of
sleep as opposed to disturbances of the REM stage. Other studies show
contradictory evidence, REM being affected by caffeine, leaving the
situation to be resolved.

The tolerance developed to caffeine's effect on sleep by coffee drinkers
has been documented by Colton (Stephenson, 1977). Non-coffee drinkers
were more sensitive to coffee's insomnic effect whereas coffee drinkers
were relatively insensitive in this regard. Non-coffee drinkers
experienced disturbed sleep patterns and delayed onset of sleep.

Mueller-Limmroth (Stephenson, 1977) showed that the quality of the first
three hours of sleep was impaired by the ingestion of coffee before
retiring. This is approximately equal to the half-life of caffeine in
the body.

Goldstein did extensive work on the effect of coffee and showed that
coffee drinkers slept more soundly when they took placebo as opposed to
caffeine in coffee. If 150 to 200 mg of caffeine was taken before
bedtime, there was an increased sleep latency which was less pronounced
in persons who were heavy ingestors of caffeine (Goldstein et al., 1965).

These studies show that caffeine has a profound effect on sleep. Heavy
and continued use of caffeine results in tolerance so that heavy users
have less sleep disturbance or need more to obtain its stimulating effect.

Treatment of Hyperkinetic Children: Hyperkinetic children have been
shown to respond to central nervous system stimulants, resulting in
improved attention, concentration, -and decreased activity. Side effects
are usually disturbing with the more powerful drugs and include
insomnia, anorexia, nervousness, weight loss and abdominal pain.

A study by Schnackenberg (1975) showed that 200 to 300 mg of caffeine
was similar in effect to methylpheniclate in treating hyperkinetic
impulse disorder secondary to minimal brain dysfunction syndrome. Some
hyperkinetic children, he observed, drank coffee to calm down. Sixteen
children who had shown improvement on methylphenidate but who had
annoying side effects were given one cup of coffee at breakfast and
lunch. Test scores showed a similar im-provement with coffee as compared
to methylpheniclate and the annoying side effects disappeared when the
children were on caffeine. Schnackenberg recommends 200 to 300 mg of
caffeine in a time-release form.

In 1977, Reichard and Elder published an article on caffeine's effect on
reaction time in hyperkinetic children. They tested the effect on a
choice reaction time task and simple reaction time as compared to normal
children. Caffeine increased the accuracy of stimulus identification and
processing and decreased lapse of attention in the hyperkinetic group.
This is what might be expected based on caffeine's known effects on such
tasks in normals. Hyperkinetic children have a slower reaction time, are
less able to maintain attention and have a lower rate of correct
responses on a vigilance performance task as compared to normal
children. In this study, six normal and six hyperkinetic children were
compared in a double-blind design. Caffeine significantly raised the
rate of correct responses on simple reaction time in the hyperkinetic
group. The reaction time was reduced with caffeine but was not
significantly less than the control period or placebo. Similar results
were found with choice reaction time. The response is a function of the
initial state of the children, i.e., the more severely afflicted had a
larger response. The authors note that other studies have shown
methylpheniclate was more effective than caffeine in controlling certain
aspects of clinical behavior (impulsivity and hyperactivity). This
result does not contradict those obtained in this study; they are
compatible.

Garfinkel was unable to confirm the results of caffeine's effectiveness
in controlling the behavior of children with minimal brain damage
(Stephenson, 1977). Children responding to methylpheniclate did not
necessarily respond to caffeine.

Firestone and associates in a study funded by the Ontario Mental Health
Foundation (1978) showed a significant improvement with methylphenidate
as rated by mothers and teachers on tests of impulsivity and motor
control. No significant improvement was noted with caffeine although
some children showed a slight improvement. Side effects with both drugs
were minimal. Each of 21 hyperactive children received 500 mg of
caffeine, 300 mg of caffeine, and 20 mg methylpheniclate. This was' a
carefully controlled study consisting of 17 boys and four girls. In
1978, Firestone did a study comparing 300 mg of caffeine with placebo in
a double-blind crossover design. In this study, subjective ratings by
teachers and parents as well as a reaction time task showed caffeine to
be better than placebo although the difference was not statistically
significant. Firestone concludes on the basis of the most recent study
that caffeine is not a meaningful alternative as a treatment for
hyperkinetic children.

The use of caffeine in the treatment of hyperkinetic children remains
unresolved at this time. Further work seems warranted to ensure that if
caffeine is useful in this prevalent condition that it be available as a
viable alternate treatment in lieu of more powerful CNS stimulants.

"Restless Legs, Anxiety and Caffeinism" (Lutz, 1978)

Restless legs is a syndrome which may be associated with anxious -
depressed as well as other clinical states. Dr. Lutz, in an article
titled as above, suggests that this syndrome is primarily caused by
caffeine. Anxiety is not a causative factor. Caffeine stimulates the
nervous system and has a direct contractile effect on striated muscle.
This is reflected in anxiety, depression, insomnia: and the heightened
proprioceptive awareness may result in restless legs. This manifestation
consists of nervousness and movement of legs as a result of a
distressing creeping sensation. Its symptoms are most obvious at night
when the patient is trying to be still, and results in insomnia. Dr.
Lutz describes cases of this disorder in detail and cites examples, all
of which were alleviated when caffeine was removed from the diet. This
condition has been attributed to many causes including psychiatric
disturbances, e.g. restless legs is a frequent symptom of hysteria,
anxiety, depression. In periods of stress, "normal" persons are also
afflicted. All of these states are associated with high central nervous
system arousal. Also, restless legs syndrome, was first described in
England at the time when coffee and tea first were introduced in the
country. Thus, diagnosis of the restless legs syndrome, as has also been
observed in certain psychological disorders, may simply be the result of
overdosage of ubiquitous caffeine.

Psychological Disorders: Dr. John Greden, a professor of psychiatry at
the University of Michigan, says, "caffeinism can be found among those
who have psychiatric problems". Symptoms of excessive caffeine
consumption are similar to anxiety neurosis (Avery, 1980) and include
nervousness, irritability, recurrent headache. twitching, and
gastrointestinal disturbance among other symptoms (Greden, 1974). This
is a known effect of caffeine and Greden adds "...all medications
including caffeine have a potential for abuse and many individuals
clearly ingest symptom-producing doses daily".

Other studies support the relationship indicated above. For example, a
prisoner with severe anxiety symptoms admitted to drinking 50 cups of
coffee per day (Niolde, 1975). The symptoms remitted after the coffee
drinking stopped. Excess drinking of coffee by prisoners is not uncommon
and may initiate a vicious cycle: a bored person drinking more coffee
resulting in caffeinism which may result in more consumption.

The intake of caffeine (coffee, etc.) has been correlated with the
degree of mental illness in psychiatric patients. It is not clear if the
caffeine intake intensifies the psychiatric disorder or whether those
with more severe problems tend to drink more coffee. In any event, in
another study by Dr. Greden and associates (Greden, 1978) 83
hospitalized psychiatric patients were interviewed and showed an
association of symptoms with high caffeine intake. This may provide an
explanation of some problems which have been experienced in diagnosing
out-patient disorders. Eighteen of the 83 patients (22 percent) were
high caffeine consumers (7~0 mg or more). They scored significantlv
higher on the State-Trait anxiety index and the Beck Depression Scale
than lower caffeine consumers. The high consumers had more clinical
symptoms: their physical health was worse; they used more sedatives,
hypnotics, and minor tranquilizers. These patients showed a tolerance to
sleep effects which could be due to a change in body kinetics or
metabolism. Catecholamines contribute to the anxiety profile and
patients may drink more coffee in response to stress, accentuating a
neuro-transmitter response cycle. Since caffeine affects catecholamine
levels and inhibits phosphodiesterase breakdown of C-AMP, sensitizing
receptor sites, the association of caffeine with anxiety and depressive
symptoms is indeed a possibility.

Dr. Greden considers caffeine to be a psychotropic drug and 25 percent
of the population may take more than 500 mg per day, a large
physiologically active dose. He describes three cases in which
caffeinism may be misdiagnosed as an anxiety syndrome.

Dr. Greden concludes that caffeine is found among a fairly large
percentage of hospitalized patients with psychiatric symptoms. Caffeine
should not be used as part of psychiatric treatment routines, e.g., to
reduce drowsiness from psychotropic medications as has been occasionally
suggested.

Dr. John Neil and associates (1978) reported on the possible
complication of caffeinism in diagnosing psychiatric patients. He
suggests that self-medication may confound behaviors of patients.
Caffeine has been considered the most popular "psychotropic" drug in
North America and coffee and tea drinking are not usually in the records
of psychiatric patients. In this experiment, hypersomnic patients with
various diagnoses and caffeine consumption participated, The authors
conclude that "self medication with large doses of caffeine is a likely
response to the anergia and hypersomnia experienced during certain types
of depression". This may lqad to diagnostic confusion and a complicated
course of therapy. Mixed depressive states may be caused by excess
caffeine consumption and they suggest, also, that unipolar 11
depressives may use more caffeine as they become depressed.

Caffeine, in these patients, provides only transitory relief as it is
not a true antidepressant. Caffeine also may render anxiolytic and
antipsychotic medications less effective.

Mikkelsen (1978) noted caffeine's involvement in schizophrenic-like
states similar to that observed by Greden in anxiety/neurosis symptoms
of patients who consumed large quantities of caffeine (coffee). One case
cited was of a white male in a catatonic state who threatened his mother
after having gone on a coffee jag over injustices caused to him by his
mother. He developed paranoid delusions which he felt were, at least in
part, due to the coffee. A 30 year old white single female exhibited
paranoid and auditory hallucinations. An anxiety state had resulted in
increased coffee consumption. in the hospital she noted the correlation
of these strange feelings with coffee consumption. Other examples of
psychotic behavior as noted in the literature are described in this
paper. Forty years ago a case of psychosis was reported in which a 24
year old female took 60 gr (about four g) of caffeine. Manic symptoms
developed. He theorizes that adenyl cyclase which is increased by
caffeine may be a receptor for dopamine. If this system is abnormal in
schizophrenics, caffeine may further sensitize the patient. Certainly,
coffee should be considered as a factor in this disease.

Reimann (1967) noted that symptoms of a psychoneurotic woman disappeared
when coffee was reduced. She presented with an irregular fever,
insomnia, anorexia and irritability, having consumed large amounts of
coffee.

Clearly, as recommended by Drs. Greden, Mikkelsen and Neil, caffeine
intake should be considered as a factor in diagnosing and treating
psychiatric patients.


CAFFEINE AND WOMEN

According to a 1999 study in Pharmacological Review, caffeine passes
through the gut quickly and becomes almost entirely active in three
quarters of an hour. Additionally, it is not prevented from going into
the human brain or the fetus, by any biological mechanism, so, in
effect, what you drink, is what you get .

Caffeine seems to have a deleterious effect upon women of childbearing
years. A 2004 study showed that consuming caffeine while the fetus is in
early gestation has been shown to increase its risk of being rejected
from the mother's body .This study was supported by data that down's
syndrome fetuses were more likely to die than genetically normal fetuses
when the mother consumed caffeinated beverages.

There does not seem to be a good time to drink coffee while pregnant: A
Danish review of clinical data over the course of 8 years (from
1996-2002) indicated that drinking coffee was related to higher levels
of mortality in the fetus, especially late in the second trimester .

Another study done in the same year at the University of Leeds showed
that drinking greater than 300 milligrams of caffeine per day while
pregnant increased the likelihood of miscarriage by 100% . Similarly, a
Scandinavian study showed that more than 375 mg of caffeine per day
increased likelihood of the loss of the fetus .

One 2003 study showed that low birth weight was found to be a factor
particularly for boy-babies born to mothers who drank more caffeine in
the last three months of pregnancy . Additionally, a Johns Hopkins study
showed that higher caffeine intake in the last 3 months of pregnancy
especially along with smoking increases likelihood of having a small baby .


Even post birth, children born to caffeine consuming mothers are more
likely to die of Crib-death .

Caffeine drinking in men may even deter conception. According to a 2002
Iranian study, caffeine caused DNA damage in human sperm, indicating
that caffeine can negatively affect a man's semen to fertilize an egg
.These changes were due to damage by oxidation.

Genetic susceptibility may play a role in the body's sensitivity to
caffeine.

Caffeine may mediate illness in the body through several genetic
variations, having to do with processing of toxins and making them
inactive in order to eliminate them from the body. Some of the initial
by-products of these initial compounds --mediated by the particular gene
(CYP1A1) have toxic and oxidative properties in the body, and several
experiments have hypothesized whether caffeine intake and these genetic
variants influence the risk of various cancers .

For some women who the specific genotype:(CYP1B1 432 Val/Val), they were
more likely to have a miscarriage during the first three months of their
pregnancy, and caffeine was also shown to influence this risk.

There is also a variant of gene called CYP1A1 that is related to higher
probability of developing cancer of the ovary when a person drinks more
than an average amount of caffeine.

And even after child bearing years, caffeine may have deleterious
effects upon the body. Drinks that have caffeine heighten the body's
process of getting rid of its stores of calcium, magnesium, zinc, and
potassium, respectively .

There is a relationship between the intake of caffeine and breaks in the
hip bones of women in the age range of 45-65 .

Additionally after menopause, intake of greater than 300 mg of caffeine
increases the likelihood of losing bone matrix in the vertebral column .

Similarly, cola intake was shown to be related to lower bone mass in
women . According to a 2005 master's degree thesis, oxidative stress due
to caffeine consumption may be a reason for development of osteoporosis
in women . The paper suggested that bone-culture cells initiated
pre-programmed cell death pathways when treated with caffeine.


SUMMARY

A review of the literature reveals that caffeine is an important factor
in modifying the psychological state of its consumers under the present
condition of usage. Caffeine is probably the most widely used drug and
those who drink coffee, tea, cola or take OTC caffeine containing drugs
are all potential and susceptible candidates. Those of us who are
"normal" can expect manifestations which may be subtle at low doses,
overt at high doses, with the possibility of being the victims of a
habit which results in tolerance and possible severe withdrawal
symptoms. The pleasant stimulant feeling which often occurs at low doses
may be replaced by psychological symptoms which resemble anxiety and
depressive neuroses at high doses. Those with more severe psychological
problems may have their symptoms exaggerated with excessive caffeine
usage, or such symptoms can actually be caused by excess. Diagnosis of
such conditions must take caffeine usage into account.

As a result of its potent physiological activity, caffeine can alter our
behavior. it affects our sleeping habits generally resulting in insomnia
and hyperactivity. Task oriented performance, attention, and
concentrations may be modified by caffeine. At lower doses, these
effects appear to be beneficial. At higher doses, we can expect the
reverse, including toxic and rebound effects.

The common "Restless Legs Syndrome" which has often been related to
psychological disturbances may, in fact, be primarily a symptom of
caffeinism according to Lutz.

Caffeine has been investigated as a possible treatment for hyperkinetic
children since central nervous system stimulants have been shown to be
effective in this condition. Results of caffeine treatment are
controversial, some studies showing a beneficial effect with little
adverse reactions and other studies showing little or no benefit.

Caffeine's effect on our body, our nervous system, our mind, our
psychology is no illusion. It is a potent drug. That it may cause
symptoms of mental illness as recently published is no small concern.
With these findings we see that caffeine abuse is more prevalent than we
may imagine. These facts should be brought to the attention of the
medical community as well as the public in order that we may have the
opportunity of being aware of the possible interactions between
ourselves and our environment.

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