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Caffeine Dependence Syndrome-Reply

Eric C. Strain, MD; Geoffrey K. Mumford, PhD; Kenneth Silverman, PhD; Roland R. Griffiths, PhD
JAMA. 1995;273(18):1418-1419. doi:10.1001/jama.1995.03520420029023.
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In Reply.  —We appreciate the comments by Drs Olekalns and Bardsley regarding the rational addiction hypothesis as applied to caffeine consumption. Their findings that, like cigarette consumption, caffeine use in the form of coffee consumption appears to follow a pattern consistent with the rational addiction hypothesis, and that this pattern of use holds both over time and in different countries, are intriguing observations.Drs Adamson and Roberts from the National Soft Drink Association express reservations about our study. They point out the study did not represent "a cross section of the US population." We agree that the subjects in this study represent a selected population. Given the lack of data on the existence of a clinical syndrome of caffeine dependence, our initial effort was simply to determine if such a syndrome existed by carefully characterizing a series of 16 cases. Eighty-eight percent had no current psychiatric diagnosis and 31% had


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