Cafeína: un nutriente, un fármaco, o una droga de abuso

Ricardo Pardo Lozano, Yolanda Alvarez García, Diego Barral Tafalla, Magí Farré Albaladejo

Resumen


El café, el té, el chocolate y los refrescos de cola son las principales fuentes de cafeína, que es consumida en casi todas las edades y estratos socioeconómicos. La cafeína es un antagonista competitivo de los receptores adenosínicos del SNC. Sus principales efectos son psicoestimulantes, respiratorios, músculo-esqueléticos y cardiovasculares. Básicamente, se metaboliza por el CYP1A2 por lo que interacciona con numerosos fármacos. Las variaciones interindividuales en su metabolismo explican las diferencias de sus efectos. Su principal uso terapéutico es como broncodilatador en patología respiratoria. Además, se ha experimentado en otras patologías con resultados no concluyentes. El consumo agudo o crónico de cafeína puede dar lugar a una amplia variedad de efectos adversos, intoxicaciones e incluso la muerte. Finalmente, destacar que la cafeína puede considerarse una droga de abuso. Así, la cafeína posee propiedades reforzadoras positivas, produce tolerancia y al cesar su consumo aparece un síndrome de abstinencia específico. La cafeína puede dar lugar a diferentes trastornos por uso de sustancias. Entre ellas la dependencia, no reconocida en el DSM IV-R, el síndrome de abstinencia y la intoxicación. La cafeína puede considerarse un fármaco, un nutriente y una droga de abuso dependiendo de su uso.


Palabras clave


Cafeina; dependencia; droga de abuso; intoxicación; reacciones adversas; farmacocinética

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Referencias


Moro MA, Lizasoain I, Ladero JM. Xantinas. En: Drogodependencias 2ª edición. Lorenzo P, Ladero JM, Leza JC, Lizasoain I, editores. Madrid: Panamericana; 2003. p. 255-62.

Arnaud MJ. The pharmacology of caffeine. Prog Drug Res 1987;31:273-313.

Smith BD, Gupta U, Gupta BS. Caffeine and activation theory. Effects on Health and Behavior. Boca Raton: CRC Press; 2007.

Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit Contam 2003;20:1-30.

Mandel HG. Update on caffeine consumption, disposition and action. Food Chem Toxicol. 2002; 40:1231-4.

http: / /www.consumasegur idad.com/web/es / normativa_legal/2003/06/30/7147.php#bibliografia

http://news.bbc.co.uk/2/hi/health/1435409.stm

Ferreira SE, de Mello MT, Pompéia S, de Souza-Formigoni ML. Effects of energy drink ingestion on alcohol intoxication. Alcohol. Clin. Exp. Res 2006;

:598-605.

Ayest a FJ, Camí J. Farmacodependencias. Farmacologia Humana 4ª edición. Flórez J, Armijo JA, Mediavilla A, editores. Barcelona: Masson; 2003. p. 595-21.

Hurlé MA. Fármacos antiasmáticos y broncodilatadores. Farmacologia Humana 4ª edición. Flórez J, Armijo JÁ, Mediavilla A, editores. Barcelona: Masson; 2003. p. 729-43.

Underm BJ. Pharmacotherapy of asthma. Brunton LL, Lazo JS, Parker KL eds. Goodman & Gilman. The Pharmacological Basis of Therapeutics. 11th ed. New Cork: McGrawHill; 2006. p. 717-36.

Ramos JA, Collazos F, Casas M. Metilxantinas. En: Manual de evaluación y tratamiento de drogodependencias. Bobes J, Casas M, Gutiérrez M, editores. Barcelona: Ars Médica; 2003. p. 335-42.

Ramos JA, Collazos F, Casas M. Adicciones a sustancias químicas (III). Psicoestimulantes. En: Tratado de Psiquiatría. Vallejo J, Leal C, editores. Barcelona: Ars Médica; 2005. p. 786-805.

Beaumont M, Batejat D, Coste O, Doireau P, Chauffard F, Enslen M, Lagarde D, Pierard C. Recovery after prolonged sleep deprivation: residual effects of slowrelease caffeine on recovery sleep, sleepiness and

cognitive functions. Neuropsychobiology 2005;51:16-27.

Lindskog M, Svenningsson P, Pozzi L, Kim Y, Fienberg AA, Bibb JA, Fredholm BB, Nairn AC, Greengard P, Fisone G.Involvement of DARPP-32 phosphorylation in the stimulant action of caffeine. Nature 2002;418:734-6.

Laska EM, Sunshine A, Mueller F, Elvers WB, Siegel C, Rubin A. Caffeine as an analgesic adjuvant. JAMA 1984;13:251.

Bara AI, Barley EA. Caffeine for asthma. Cochrane Database Syst Rev 2000;2:CD001112.

William R. Lovallo; Michael F. Wilson; Andrea S. Vincent; Bong Hee Sung; Barbara S. McKey; Thomas L. Whitsett. Blood Pressure Response to Caffeine Shows Incomplete Tolerance After Short-Term Regular Consumption. Hypertension 2004;43:760-765.

Taubert D, Roesen R, Lehmann C, Jung N, Scho¨ mig E. Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide. A Randomized Controlled Trial. JAMA 2007;298:49-60.

Lars Frost and Peter Vestergaard. Caffeine and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study. Am J Clin Nutrition 2005;81:578-82

Du Y; Melchert HU; Knopf H; Braemer-Hauth M; Gerding B; Pabel E. Association of serum caffeine concentrations with blood lipids in caffeine-drug users and nonusers – Results of German National Health Surveys from 1984 to 1999. Europ J Epidem 2005;20:311-6.

Cheung RJ Gupta EK, Ito MK. Acute Coffee Ingestion Does Not Af fect LDL Cholesterol Level. Ann Pharmacother 2005;39:1209-13.

Rob M. van Dam, Wilrike J. Pasman, Petra Verhoef. Effects of Coffee Consumption on Fasting Blood Glucose and Insulin Concentrations. Randomized controlled trials in healthy volunteers. Diabetes Care

;27:2990-2.

Tianying Wu, Walter C. Willett, Susan E. Hankinson, Edward Giovannucci. Caffeinated Coffee, Decaffeinated Coffee, and Caffeine in Relation to Plasma C-Peptide Levels, a Marker of Insulin Secretion, in U.S. Women. Diabetes Care 2005;28:1390-6.

Gottlieb S. More coffee, fewer gallstones.BMJ 1999;318:1646.

Chandrasekaran S; Rochtchina E. Effects of Caffeine on Intraocular Pressure: The Blue Mountains Eye Study. J Glaucoma 2005;14:504-7.

Jong Weon Choi. Influence of caffeine on the responsiveness of human platelet to agonists. Thrombosis Research 2003;110:209-12.

Christian MS, Brent RL.Teratogen update: evaluation of the reproductive and developmental risks of caffeine. Teratology 2001;64:51-78.

Alison Taylor. ABC of subfertility. BMJ 2003;327:434-6.

Mildred S. Christian, Robert L. Brent. Teratogen update: Evaluation of the reproductive and developmental risks of caffeine. Teratology 2001;64:51-78.

J. L. Mills, L. B. Holmes, J. H. Aarons, J. L. Simpson, Z. A. Brown, L. G. Jovanovic et al. Moderate caffeine use and the risk of spontaneous abortion and intrauterine growth retardation. JAMA 1993;269:593-7.

Giannelli M.; Doyle P.; Roman E.; Pelerin M.; Hermon C. The effect of caffeine consumption and nausea on the risk of miscarriage. Paediatric & Perinatal Epidemiology 2003;17:316-23.

Fetal loss associated with caffeine intake before and during pregnancy. C. Infante-Rivard, A. Fernandez, R. Gauthier, M. David and G. E. Rivard. JAMA 1993;270(24).

Sven Cnat t ingius, Lisa B. Signorel lo, Göran Annerén, Britt Clausson, Anders Ekbom, Elisabeth Ljunger et al. Caffeine Intake and the Risk of First-Trimester Spontaneous Abortion. New Engl J Med 2000;343:1839-45.

Fumihiro Sata, Hideto Yamada, Kana Suzuki, Yasuaki Saijo, Emi H Kato, Mamoru Morikawa et al. Caffeine intake, CYP1A2 polymorphism and the risk of recurrent pregnancy loss. Mol Hum Reprod 2005;11:357-60.

Michael B. Bracken; Elizabeth W. Triche; Kathleen Belanger; Karen Hellenbrand; Brian P. Leaderer. Association of Maternal Caffeine Consumption with Decrements in Fetal Growth American J Epidem

;157:456-66.

Derek G Cook, Janet L Peacock, Colin Feyerabend, Iain M Carey, Martin J Jarvis, H Ross Anderson et al. Relation of caffeine intake and blood caffeine concentrations during pregnancy to fetal growth: prospective population based study. BMJ 1996; 313:1358-62.

Janet L Peacock, J Martin Bland, H Ross Anderson. Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine. BMJ 1995;311:531-5.

Donovan JL, DeVane CL. A primer on caffeine pharmacology and its drug interactions in clinical psychopharmacology. Psychopharmacol Bull 2001; 35:30-48.

Fuhr U, Rost KL. Simple and reliable CYP1A2 phenotyping by the paraxanthine/caffeine ratio in plasma and in saliva. Pharmacogenetics 1994; 4:109-16.

Car r i l lo JA, Beni tez J. Cl inic al ly signi f ic ant pharmacokinetic interactions between dietar y caffeine and medications. Clin Pharmacokinet 2000; 39:127-53.

Swanson JA, Lee JW, Hopp JW, Berk LS.The impact of caffeine use on tobacco cessation and withdrawal. Addict Behav. 1997;22:55-68.

Kari R, Virpi R, Jouko L, Pertti N. Effect of Caffeine- Containing versus Decaffeinated Coffee on Serum Clozapine Concentrations in Hospitalised Patients Basic Clin Pharmacol Toxicol 2004;94:13-8.

Shioda K, Nisijima K, Nishida S, Kato S. Possible serotonin syndrome arising from an interaction between caffeine and serotonergic antidepressants. Hum Psychopharmacol Clin Exp 2004;19:353-4.

Jones HE, Griffiths RR. Oral caffeine maintenance potentiates the reinforcing and stimulant subjective effects of intravenous nicotine in cigarette smokers. Psychopharmacology (Berl). 2003;165:280-90.

Hughes JR, Oliveto AH. Coffee and alcohol intake as predictors of smoking cessation and tobacco withdrawal. J Subst Abuse 1993;5:305-10.

Brenda Eskenazi. Caffeine Filtering the Facts. NEJM 1999;22:1688-1689.

Broderick P, Benjamin AB. Caffeine and psychiatric symptoms: a review. J Okla State Med Assoc. 2004;97:538-42.

S. Infante, M. L. Baeza, M. Calvo, M. De Barrio, M. Rubio, T. Herrero. Anafilaxia por cafeína. Allergy 2003; 58:680-690

M. Fernández-Nieto, J. Sastre, S. Quince. Urticaria from coke. Allergy 2002;57:967.

Papamichael CM, Aznaouridis KA, Karatzis EN, Karatzi KN, Stamatelopoulos KS, Vamvakou G, et al. Effect of coffee on endothelial function in healthy subjects: the role of caffeine. Clin Sci 2005;109:55-60.

Editorial. Coffee intake and death from coronary heart disease. BMJ 1996;312:1539

Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 Genotype, and Risk of Myocardial Infarction. JAMA. 2006;295:1135-41

Willett WC, Stampfer MJ, Manson JE, Colditz GA, Rosner BA, Speizer FE, Hennekens CH. Coffee consumption and coronary heart disease in women. A ten-year follow-up. JAMA 1996;275:458-62

Compston JE, Cooper C, Kanis JA. Fortnightly Review: Bone densitometry in clinical practice. BMJ 1995;310:1507-1510.

Barrett-Connor E, Chang JC, Edelstein SL. Coffeeassociated osteoporosis of fset by daily milk consumption. The Rancho Bernardo Study. JAMA 1994; 271:280-3.

Focking M, Schmiegelt D, Trapp T. Caffeine-mediated enhancement of glucocorticoid receptor activity in human osteoblastic cells. Biochem Biophys Res Commun. 2005;337:435-9.

Kovacs EMR, Lejeune MPGM, Nijs I, Westerterp- Plantenga MS. Effects of green tea on weight maintenance after body-weight loss. Br. J. Nutr. 2004; 91:431-7.

Zhang WY. A benefit-risk assessment of caffeine as an analgesic adjuvant. Drug Saf 2001;24:1127-42.

Jayna M. Holroyd-Leduc, Sharon E. Straus. Management of Urinary Incontinence in Women. JAMA2004; 291:986-995

Wendl B, Pfeiffer A, Pehl C, Schmidt T, Kaess H. Effect of decaffeination of coffee or tea on gastrooesophageal reflux. Aliment Pharmacol Ther 1994; 8:283-287.

Henderson-Smar t DJ, Davis PG.Prophylactic methylxanthines for extubation in preterm infants. Cochrane Database Syst Rev. 2003;1:CD000139.

Hering-Hanit R; Gadoth N. Caffeine-induced headache in children and adolescents. Cephalalgia, 2003; 23:332-335.

Regestein QR. Pathologic sleepiness induced by caffeine. Am J Med 1989; 87:586-588.

Porta M, Vioque J, Ayude D, Alguacil J, Jariod M, Ruiz L et al. Coffee drinking: the rationale for treating it as a potential effect modifier of carcinogenic exposures. Eur J Epidemiol 2003; 18:289-298.

Juliano LM, Griffiths RR. Caffeine. In: Lowinson JH, Ruiz P, Millman RB, Langrod JG, editors. Substance Abuse. A Comprehensive Textbook. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 403-421.

Pentel P. Toxicity of over-the-counter stimulants. JAMA 1984;252:1898-903.

Donnerstein RL, Zhu D, Samson R, Bender AM, Goldberg SJ. Acute effects of caffeine ingestion on signal-averaged electrocardiograms. Am Heart J. 1998;136:574-5.

Ergenekon E, Dalgic N, Aksoy E, Koc E, Atalay Y. Caffeine intoxication in a premature neonate. Paediatr Anaesth. 2001;11:737-9.

Holmgren P, Norden-Pettersson L, Ahlner J. Caffeine fatalities-four case repor ts. Forensic Science International 2004;139:71-73.

Kerrigan S, Lindsey T. Fatal caffeine overdose: two case reports. Forensic Sci Int. 2005;153:67-9.

Rice JE, Faunt JD. Excessive cola consumption as a cause of hypokalaemic myopathy. Int Med J 2001; 31:317-8.

Bhatia J. Current options in the management of apnea of prematurity. Clin Pediatr (Phila) 2000;39:327-36.

Anonymous. Relationship Between Caffeine Intake and Parkinson Disease. JAMA 2000;284:1378-7.

Ascherio A, Weisskopf MG, O’Reilly EJ, McCullough ML, Calle EE, Rodriguez C et al. Coffee consumption, gender, and Parkinson’s disease mortality in the Cancer prevention Study II Cohort: The Modifying

Effects of Estrogen. Am J Epidem 2004;160:977-84.

Ross GW, Abbott RD, Petrovitch H, Morens DM, Grandinetti A, Tung KH, Tanner CM, Masaki KH, Blanchette PL, Curb JD, Popper JS, White LR.

Association of coffee and caffeine intake with the risk of Parkinson disease. JAMA 2000;283:2674-6.

Chen JF, Xu K, Petzer JP, Staal R, Xu YH, Beilstein Met al.Neuroprotection by caffeine and A(2A) adenosine receptor inactivation in a model of Parkinson’s disease. J Neurosci. 2001;21:RC143.

Dall’lgna OP, Porciúncula LO, Souza DO, Cunha RA and Lara DR. Neuroprotection by caffeine and adenosine A2A receptor blockade of -amyloid neurotoxicity. British Journal of Pharmacology 2003;138:1207−9

Fink JS, Kalda A, Ryu H, Stack EC, Schwarzschild MA, Chen JF et al. Genetic and pharmacological inactivation of the adenosine A2A receptor attenuates 3-nitropropionic acid-induced striatal damage. J Neurochem 2004;88:538-44.

Karin B. Michels; Walter C. Willett; Charles S. Fuchs; Edward Giovannucci. Coffee, Tea, and Caffeine Consumption and Incidence of Colon and Rectal Cancer. Journal of the National Cancer Institute. 2005;

:282-92.

Alessandra TAVANI, Alberto PREGNOLATO, Carlo LA VECCHIA, Eva NEGRI, Renato TALAMINI and Silvia FRANCESCHI. Coffee and tea intake and risk of cancers of the colon and rectum: a study of 3,530 cases and

,057 controls. Int. J. Cancer 1997;73:193–7

Klatsky AL, Morton C, Udaltsova N, Friedman GD. Coffee, cirrhosis, and transaminase enzymes. Arch Intern Med 2006;166:1190-5

Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutrition 2005;81:611-4.

Van Dam RB, Hu FB. Coffee Consumption and Risk of Type 2 Diabetes. JAMA. 2005;294:97-104.

Pasqualotto FF, Lucon AM, Sobreiro BP, Hallak J, Pasqualotto EB, Arap S. Does caffeine intake impair semen quality and hormonal levels in a fertile population?. Fertility and Sterility 2003;80:231-3.

Penelope M. Webb, Celia Byrne, Stuart J. Schnitt, James L. Connolly, Timothy W. Jacobs, Heather J. Baer et al. A Prospective Study of Diet and Benign Breast Disease. Cancer Epidemiol Biomarkers Prev

;13:1106-13.

André Nkondjock, Parviz Ghadirian, Joanne Kotsopoulos, Jan Lubinski, Henry Lynch , Charmaine Kim et al. Coffee consumption and breast cancer risk among BRCA1 and BRCA2 mutation carriers. Internacional Journal of Cancer 2005; 118:103-7.

Larsson SC, Wolk A. Tea consumption and ovarian cancer risk in a population-based cohort. Arch Intern Med 2005; 165:2683-6

Yang, Haiyan; Rouse, Jessica; Lukes, Luanne; Lancaster, Mindy; Veenstra, Timothy; Zhou, Ming et al. Caffeine suppresses metastasis in a transgenic mouse model: a prototype molecule for prophylaxis of metastasis. Clin. Exp Metastasis. 2004;21:719-35.

Kendler KS, Prescott CA. Caffeine intake, tolerance, and withdrawal in women: a population-based twin study. Am J Psychiatry 1999; 156:223-228.

Swan GE, Carmelli D, Cardon LR. Heavy consumption of cigarettes, alcohol and coffee in male twins. J Stud Alcohol 1997; 58:182-90.

Hettema JM, Corey LA, Kendler KS. A multivariate genetic analysis of the use of tobacco, alcohol, and caffeine in a population based sample of male and female twins. Drug Alcohol Depend 1999;57:69-78.

American Psychiatric Association DSM-IV-TR. Manual diagnóstico y estadístico de los trastornos mentales -IV - Texto revisado. Barcelona: Elsevier-Masson; 2001.

Strain EC, Mumford GK, Silverman K, Griffiths RR. Caffeine dependence syndrome. Evidence from case histories and experimental evalations. JAMA 1994;272:1065-6.

Nehlig A. Are we dependent upon coffee and caffeine? A review on human and animal data. Neurosci Biobehav Rev 1999;23:563-76.

Stern KN, Chait LD, Johanson CE. Reinforcing and subjective effects of caffeine in normal human volunteers. Psychopharmacology 1989;98:81-8.

Griffiths RR, Bigelow GE, Liebson IA. Human coffee drinking: reinforcing and physical dependence producing effects of caffeine. J Pharmacol Exp Ther 1986;239: 416-25.

Griffiths RR, Bigelow GE, Liebson IA, O´Keffe M, O´Leary D, Russ N. Human coffee drinking: manipulation of concentration and caffeine dose. J

Exp Anal Behav 1986;45:133-48.

Griffiths RR, Bigelow GE, Liebson IA. Reinforcing effects of caffeine in coffee and capsules. J Exp Anal Behav 1989;52:127-40.

Hughes JR, Higgins ST, Bickel WK, Hunt WK, Fenwick JW, Gulliver SB, Mireault GC. Caffeine selfadmistration, withdrawal, and adverse effects among coffee drinkers. Arch Gen Psychiatry 1991;48:611-7.

Hughes JR, Hunt WK, Higgins ST, Bickel WK, Fenwick JW, Pepper SL. Effect of dose on the ability of caffeine to serve as a reinforcer in humans. Behav Pharmacol 1992;3:211-8.

Oliveto AH, Hughes JR, Pepper SL, Bickel WK, Higgins ST. Low doses of caffeine can serve as reinforcers in humans. NIDA Res Monogr 1991;105:442.

Grif fiths RR, Woodson PP. Caf feine physical dependence: a review of human and laboratory animal studies. Psychopharmacology 1988;94:437-51.

Shi J, Benowitz NL, Denaro CP, Sheiner LB. Pharmacolinetic-pharmacodynamic modelling of caffeine: tolerance to pressor effects. Clin Pharmacol Ther 1993;53:6-14.

Eddy NB, Downs AW. Tolerance and cross-tolerance in the human subject to the diuretic effect of caffeine, theobromine and theophylline. J Pharmacol Exp Ther 1928;33:345-9.

Denaro CP, Brown CR, Wilson M, Jacob III P, Benowitz NL. Dose-dependency of caffeine metabolism. Clin Pharmacol Ther 1990;31:277-85.

Juliano LM, Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology (Berl). 2004;176:1-29.




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