RESEARCH ARTICLE


Panic Disorder and Chronic Caffeine Use: A Case-control Study



Veruska Andrea Santos1, Silvia Hoirisch-Clapauch2, Antonio E. Nardi1, Rafael Christophe Freire1, 3, *
1 Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
2 Hospital Federal dos Servidores do Estado, Ministry of Health, Rio de Janeiro, Brazil
3 Department of Psychiatry, Queen’s University, Kingston, Canada


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Creative Commons License
© 2019 Freire et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at dult Mental Health Program, Hotel Dieu Hospital, 166 Brock Street, Kingston, ON, Canada; Tel: +1 613-544-3400 Ext. 2551; Fax: +1 613-548-6095; E-mail: rafael.freire@queensu.ca


Abstract

Background:

Acute administration of caffeine produces panic attacks in most Panic Disorder (PD) patients, but little is known about chronic caffeine use in these patients.

Objective:

To assess caffeine use in patients with PD and to ascertain if caffeine consumption is associated with sociodemographic or clinical features.

Methods:

65 adults with PD and 66 healthy controls were included in the current study. Their caffeine intake within the previous week was quantified with a questionnaire and compared. Harmful caffeine use was defined as consumption above 400 mg/day of caffeine. We tested for correlations between caffeine intake, demographic and clinical features.

Results:

Patients consumed significantly more caffeine than controls (P < 0.001). 14% (N = 9) of the PD patients made harmful use of caffeine. The use of caffeine-containing medications was observed in 40% (N = 26) of the PD patients and 6% (N = 4) of controls. Consumption of energy drinks was observed in 11% (N = 7) of PD patients and in none of the healthy subjects. Patients reported sleeping significantly less than controls (P < 0.001). In PD patients, caffeine consumption was not correlated with the presence of panic attacks or comorbidity with depression. The use of benzodiazepines or sedative medications was not correlated with caffeine intake.

Conclusion:

High caffeine consumption in PD patients could be explained by the development of tolerance with regular use of this substance. Subtypes of sensitive and non-sensitive PD patients could also explain why some of these patients are able to tolerate high doses of caffeine.

Keywords: Caffeine, Adenosine receptors, Panic disorder, Panic attacks, Sleep deprivation, Self medication.