Caffeine-induced Augmentation of Antidepressant Therapy

Depressed patients receiving antidepressant treatment for therapeutic purpose also consume caffeine in the form of tea or coffee drinks as a part of their daily life. These depressed patients seek a “lift” because of fatigue or negative affect, thereby consuming high amount of caffeine as a self-medication to increase alertness. This further may lead to increased negative affect and depressive symptoms. Unfortunately, many studies evaluating caffeine in youth have considered samples belonging to either moderate or higher level of caffeine intake. Caffeine, as a psychomotor stimulant, is known to inhibit the pre- and postsynaptic brakes imposed by adenosine on dopaminergic neurotransmission. Evidences also indicate an important role of caffeine as an adenosine receptor blocker in depression treatment. Caffeine may help in the treatment of chronic depression by potentiating dopaminergic system. Antidepressant agents are known to normalize depressed mood by influencing a variety of neurotransmitter systems including dopamine. Evidences suggest a possible positive effect on dopaminergic activity of caffeine augmentation (10 mg/kg or lower dose) with antidepressant agents for depression treatment. These findings suggest a need of considering and future evaluation of possible beneficial effects of low dose of caffeine augmentation with antidepressants in depressed patients.