Can caffeine induce a panic attack?

by Rebecca Israel, MS, Sabrina Drumond, Charles Li, MD

June 26, 2020

  • Caffeine may contribute to panic attack onset in those with existing panic disorders.

  • There is no evidence that caffeine induces panic attacks in those who would not typically experience them.

  • Those with performance social anxiety disorder responded to caffeine in a similar way as those with panic disorders.

caffeine and panic attacks title

Panic attacks are a symptom of panic disorder, anxiety disorders, mental disorders, and some medical conditions. A panic attack can cause an increased heart rate, sweating, dizziness, headache, chest pain, and nausea. Everyone experiences a panic attack differently.

Caffeine is known to increase heart rate or cause headaches, similar to a panic attack. In this article, we discuss studies that have reviewed the relationship between panic attacks and caffeine consumption.

Caffeine and Panic Disorders

Does caffeine induce panic attacks in those with and without panic disorders?

Source: Caffeine challenge test in panic disorder and depression with panic attacks

Researchers studied the caffeine responses of participants with panic disorder (PD), major depression with panic attacks (MDP), major depression without panic attacks (MD), and health volunteers. Participants were asked to relax for 10 minutes, then drank either coffee or decaf coffee. Over the next 30 minutes, researchers checked respiratory frequency, pulse rate, and blood pressure. Both participants and examiners rated panic experiences.

After caffeine consumption, 58.6% of patients with PD, 44.4% of patients with MDP, 12.0% of patients with MD, and 7.1% of control subjects exhibited symptoms of a panic attack. The findings suggest an association between panic attacks and caffeine intake. The likelihood of a panic attack was significantly higher in those with panic attack-related disorders.

Interestingly, patients with major depression had a lower heart rate response than any other group. An important takeaway from this study is that caffeine may contribute to panic attack onset in those with existing panic disorders, but is unlikely to induce panic attacks in those who do not typically experience them.

Caffeine and Social Anxiety

Another study, led by the same doctor, wanted to further explore the effect of caffeine on patients with other psychiatric disorders. This time, they conducted a nearly identical experiment on patients with panic disorder (PD), generalized social anxiety disorder (GSAD), performance social anxiety disorder (PSAD), and healthy controls.

Similar to the previous study, panic attack symptoms were more common in subjects with a history of panic attacks. 60.7% of panic disorder patients, 52.6% of performance social anxiety disorder patients, and 16% of generalized social anxiety disorder patients had a panic attack after the caffeine test. There were no panic attacks among healthy controls or after placebo intake.

All groups were sensitive to caffeine and experienced some level of increased anxiety after consumption. Panic disorder and performance social anxiety disorder subjects reported the most panic attack symptoms, Generalized social anxiety disorder and controls reported a different set of symptoms.

Source: Panic Disorder and Social Anxiety Disorder Subtypes in a Caffeine Challenge Test

This result may help to demonstrate that performance social anxiety disorder is a group that is biologically different from the generalized social anxiety disorder group and biologically more similar to panic disorder. They may share some common cognitive and/or learning factors that predispose them to respond in a more similar way.

Takeaways

The studies considered factors like age, gender, and family history when analyzing their data. Though the results are significant, we can not strongly associate caffeine and panic attacks without considering other variables that could be interfering in the relationship. Do people who drink more coffee also drink more alcohol? Do people who drink more coffee exercise less? These are the kinds of questions that would need to be assessed in a much larger sample.

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