Caffeine and Panic Attacks

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Caffeine and Panic Attacks: What’s the Association?

Panic attacks strike fear in the hearts of those who have them – because the symptoms can come on anytime and anywhere. The rapid heart rate, sweating, overwhelming sense of fear, dizziness, and fear of losing control can wreak havoc on the professional and social life of people who suffer from panic attacks. Most doctors advise people with panic attacks to avoid coffee and other caffeinated beverages. Is there a link between caffeine and panic attacks?

How Does Caffeine Affect Panic Disorder?

Caffeine is a stimulant that not only speeds up the heart rate, but exerts its “energizing” effects on the central nervous system as well. Even normal people experience overstimulation and anxiety after drinking caffeinated beverages, so it’s not surprising that caffeine could make panic attacks worse. Some of the symptoms of caffeine intoxication mimic those of panic attacks including anxiety, shakiness, sweating, flushing, and a rapid heart rate.

What Do Studies Show About Caffeine and Panic Attacks?

According to a study presented at the American Psychiatric Association 2007 Annual Meeting, people who have panic attacks are more likely to experience symptoms after consuming caffeine. They also found a similar association in people with major depression.

When participants who had a history of panic attacks drank a solution containing 450 milligrams of caffeine or an un-caffeinated placebo, the group who got the caffeine felt more anxious and were significantly more likely to have a panic attack. It may be that people who suffer from panic attacks are more sensitive to the central nervous system effects of caffeine than normal people are.

Why Does Caffeine Worsen Panic Attacks?

Caffeine stimulates the release of certain stress hormones including epinephrine, norepinephrine, and cortisol. Epinephrine, also known as adrenaline, plays a role in the “fight-or-flight” response to stress, a reaction which speeds up the heart and breathing rate to prepare a person to fight or escape from a dangerous situation rapidly. When this happens in the absence of a threat, it could trigger the symptoms of a panic attack.

Another link between caffeine and panic attacks is how caffeine affects adenosine receptors in the brain. When adenosine binds to these brain receptors, it has a calming or sedative-like effect. At the same time, it dilates blood vessels so that more oxygen reaches the brain. When caffeine comes on the scene, it blocks some of the adenosine receptors, which leads to blood vessel constriction, less oxygen, and more stimulation of the brain. As you might expect, this isn’t a good thing for a person with panic attacks. Habitual coffee drinkers eventually develop tolerance to the effects of caffeine so that it no longer causes the same degree of nervous system stimulation.

Caffeine and Panic Attacks: The Bottom Line?

There does seem to be a link between caffeine and panic attacks, and it may increase the risk of panic attacks by its effect on epinephrine or adenosine in the brain. Although the exact mechanism isn’t known, it’s still wise for people with panic attacks to steer clear of caffeine.


Neurochem 79 (3): 463–84. “Caffeine Challenge Induced Panic Attacks in Patients with Panic Disorder”