Replace Your Meds With Coffee? What You Need to Know About Caffeine and Adult ADHD

Every ADHD diagnosis is personal and how you manage your symptoms may differ from how others handle theirs. Many adults with ADHD find that stimulant medication helps, while others opt for a cup of coffee or a canned energy drink instead. Are caffeine and stimulant meds interchangeable? Here’s what experts say.

The world’s most popular stimulant

Caffeine is the most commonly used psychostimulant substance in the world, and the vast majority of adults consume caffeine in amounts large enough to impact the brain. According to the Food and Drug Administration, up to 400 mg of caffeine daily is safe for healthy adults. (A typical cup of coffee has about 100 mg of caffeine.)

Some caffeine, like that found in coffee and chocolate, is naturally occurring. Other foods and beverages, such as energy drinks and power bars, are fortified with added caffiene to promote increased energy, alertness and mood. Caffeine is also present in an array of over-the-counter medicine and even as ready-made “caffeine pills.”

Caffeine in lieu of meds?

Some studies have shown that caffeine may improve concentration in adults with ADHD. Caffeine stimulates the central nervous system by affecting the neurotransmitters that influence alertness and cognitive thinking. As adenosine (a cell compound that signals the body to wind down) increases, drowsiness occurs. Caffeine hijacks the receptors that adenosine would latch onto.

But neuropsychologist Sam Goldstein, the editor in chief of the Journal of Attention Disorders and an adjunct assistant professor in the Department of Psychiatry at the University of Utah School of Medicine, urges caution when replacing ADHD medications with caffeine. Goldstein explains that caffeine may not be as effective in improving attention as methylphenidate (Ritalin, Concerta) or mixed salts of amphetamine (Adderall).

Ben Spielberg is a neuroscientist and the founder of TMS & Brain Health, a California-based brain health center that provides Transcranial Magnetic Stimulation and other therapies for depression, ADHD and other conditions. Spielberg explains that caffeine works on a very different pathway than the typical stimulants used for ADHD. “Many studies have examined the effects of caffeine on cognition and ADHD,” he says. “While stimulants almost always show positive efficacy in clinical trials, researchers haven’t funded many large-scale studies looking at caffeine as a potential intervention for ADHD.”

Caffeine in addition to meds?

Goldstein recommends not combining caffeine with meds either. For one reason, caffeine may reduce the effectiveness of the medications. And because the caffeine and meds have similar effects on the body, “there may be a high risk of side effects and health problems when using them together,” he warns.

“Some research has shown that people with ADHD tend to have higher caffeine intake than their neurotypical counterparts,” says Spielberg. This suggests that people with ADHD may be unknowingly self-medicating by supplementing with caffeine.

Too much caffeine is unhealthy. Side effects can include heart palpitations, agitation, anxiety, insomnia and increased blood pressure and heart rate. Benjamin Fisher, a Portland, Ore., resident with ADHD, experienced caffeine side effects firsthand.

“I can confirm that it is possible to reach a similar level of focus using caffeine instead of stimulation medications, but I wouldn’t recommend it,” Fisher says. Before his ADHD was diagnosed, Fisher was consuming 300 to 390 milligrams of caffeine every day to stay on task. After the official diagnosis, he replaced the caffeine with Adderall.

“At 24, I was getting chest pains from too much caffeine,” Fisher says. “Now, I’m accomplishing the same amount of work — if not more — using medication instead.”


Lakartidningen (Swedish Medical Journal)

Frontiers in Psychiatry

Genes, Brain and Behavior