Other medical disorders and medical side effects. Several disorders should be consid- ered in the differential diagnosis of caffeine withdrawal. Caffeine withdrawal can mimic migraine and other headache disorders, viral illnesses, sinus conditions, tension, other drug withdrawal states (e.g., from amphetamines, cocaine), and medication side effects.
The final determination of caffeine withdrawal should rest on a determination of the pat- tern and amount consumed, the time interval between caffeine abstinence and onset of symptoms, and the particular clinical features presented by the individual. A challenge dose of caffeine followed by symptom remission may be used to confirm the diagnosis.
Caffeine withdrawal may be associated with major depressive disorder, generalized anx- iety disorder, panic disorder, antisocial personality disorder in adults, moderate to severe alcohol use disorder, and cannabis and cocaine use.
The following caffeine-induced disorders are described in other chapters of the manual with disorders with which they share phenomenology (see the substance/medication- induced mental disorders in these chapters): caffeine-induced anxiety disorder (”Anxiety
Disorders”) and caffeine-induced sleep disorder (”Sleep-Wake Disorders"). These caf- feine-induced disorders are diagnosed instead of caffeine intoxication or caffeine with- drawal only when the symptoms are sufficiently severe to warrant independent clinical attention.
292.9 (F15.99)
This category applies to presentations in which symptoms characteristic of a caffeine- related disorder that cause clinically significant distress or impairment in social, occupa- tional, or other important areas of functioning predominate but do not meet the full criteria for any specific caffeine-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.
A. A problematic pattern of cannabis use leading to clinically significant impairment or dis- tress, as manifested by at least two of the following, occurring within a 12-month period: 1.
2.
3.
10.
11.
Cannabis is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
A great deal of time is spent in activities necessary to obtain cannabis, use canna- bis, or recover from its effects.
Craving, or a strong desire or urge to use cannabis.
Recurrent cannabis use resulting in a failure to fulfill major role obligations at work, school, or home.
sonal problems caused or exacerbated by the effects of cannabis.
Important social. occupational. or recreational activities are given up or reduced be- cause of cannabis use.
Recurrent cannabis use in situations in which it is physically hazardous.
Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
Tolerance, as defined by either of the following: a. A need for markedly increased amounts of cannabis to achieve intoxication or desired effect.
b. Markedly diminished effect with continued use of the same amount of cannabis.
Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for cannabis (refer to Criteria A and B of the criteria set for cannabis withdrawal. pp. 517—518).
b. Cannabis (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.
Specify it:
In early remission: After full criteria for cannabis use disorder were previously met, none of the criteria for cannabis use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, "Craving, or a strong de- sire or urge to use cannabis,” may be met).