Post-stimulant neurovascular–psychosomatic response (PSSP) after combined caffeine–nicotine exposure: a self-case report with a mechanistic hypothesis

Background: Combined caffeine-nicotine exposure may trigger a biphasic neurovascular-autonomic reaction in susceptible individuals. Case presentation:We report a retrospective self-observed case following routine dual-stimulant exposure.Within 1-3 h the patient developed vasomotor instability, sensory hypersensitivity and anxiety, followed by a delayed migraine-like phase.Vital signs and symptom ratings were tracked over time.Discussion: We hypothesize a dopaminergic activation -cholinergic/autonomic rebound mechanism with neurovascular sensitization.The pattern differs from nicotine withdrawal and panic attacks and yields testable diagnostic predictions (HRV, inflammatory markers, thermography).Conclusions: Recognizing PSSP may help clinicians avoid misattribution of transient stimulant-induced reactions to primary vascular or psychiatric crises.