December 16, 2005

Family alcoholism may make going decaf tough

NEW YORK (Reuters Health) - Women who are both hooked on
caffeine and have a family history of alcoholism may have an
especially tough time giving up their morning coffee during
pregnancy, a small study has found.

The study of 44 pregnant women found that while most gave
up or cut down on caffeine, those with both caffeine dependence
and a family history of alcoholism were much less likely to be

The findings, according to researchers, suggest that a
genetic vulnerability toward addiction in general makes the
caffeine habit hard to break for some.

Dr. Dace S. Svikis of Virginia Commonwealth University in
Richmond led the study. The findings are published in the
American Journal of Psychiatry.

Though studies have yielded conflicting results on the
effects of caffeine use during pregnancy, some have linked it
to an increased risk of miscarriage, impaired fetal growth and
other complications. To be safe, health authorities in the U.S.
and other countries advise pregnant women to abstain from
caffeine or at least limit their intake.

But whether caffeine dependence is a substantial barrier
for many women is unclear.

Caffeine dependence is not recognized as an official
psychiatric diagnosis, as dependence on alcohol and other drugs
is. Still, a number of studies have suggested it's a valid
diagnosis, Svikis and her colleagues note.

Caffeine users have been found to show the classic signs of
dependence -- including a need to have increasing amounts in
order to feel the desired effect; withdrawal symptoms when they
attempt to quit; and being unable to quit even though they want

In the current study, more than half of the women met the
definition for caffeine dependence at some point in their
lives. These women were less likely to be able to give up
caffeine after learning they were pregnant -- despite the fact
that all women in the study were advised by their doctors to
cut out or at least cut down on caffeine.

But it was those women with both caffeine dependence and a
family history of alcoholism who had the toughest time shunning

During their first prenatal check-up, 14 percent of these
women said they'd abstained from caffeine over the past week,
versus 50 percent of women with neither caffeine dependence nor
a family history of alcoholism. At the second prenatal visit,
those figures were 21 percent and 63 percent, respectively.

Moreover, the researchers found, half of women with both
caffeine dependence and alcoholism in the family continued to
consume caffeine in excess of what's considered safe during
pregnancy -- more than 300 milligrams per day, which is roughly
equivalent to three cups of coffee.

Headache, fatigue, craving and difficulty getting through
daily tasks were among the common reasons women cited for
failing to cut back on caffeine.

Overall, Svikis and her colleagues write, the findings
suggest that a "genetic vulnerability reflected in a family
history of alcoholism may be necessary to express the
problematic features of caffeine dependence."

Pregnant women who are both hooked on caffeine and have
alcohol problems in the family, they conclude, may need
stronger help from their doctors in cutting out caffeine.

SOURCE: American Journal of Psychiatry, December 2005.