Психотическая симптоматика после злоупотребления энергетическими напитками у больного шизофренией

Caffeine functions in the central nervous system as a competitive antagonist of adenosine receptors, A1 and A2A, and alters neurotransmitter release, including dopamine and glutamate. This dopamine release in the striatum may underlie caffeine's reinforcing properties, and the modulation of the mesolimbic dopamine pathway may be related to its psychotomimetic effect (1). Exaggerated effects may be seen in patients with schizophrenia using high-dose caffeine (2). The energy drink the patient in the present case consumed contained 160 mg of caffeine per can. The patient weighed 67 kg and therefore consumed approximately 20 mg/kg per day of caffeine. Psychosis has been reported at doses near 10 mg/kg per day (3), which is well below the known toxic dosage (150–200 mg/kg) but above the average intake by the numerous schizophrenia outpatients who use caffeine (1.8–4.1 mg/kg per day [depending on smoking status]) (4).

Psychosis Following Excessive Ingestion of Energy Drinks in a Patient With Schizophrenia