Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C


OBJECTIVE: The objective for this selective EMB review is to determine whether or not the reduction of caffeine intake is effective in reducing the symptoms of panic attack in panic disorder patients.

STUDY DESIGN: Review of three English language randomized control trials published in 2007, 2008, and 2009.

DATA SOURCES: The double-blind placebo-controlled randomized control trials were obtained via PubMed.

OUTCOMES MEASURED: The prevalence of a clinical panic attack. Pre and post caffeine/placebo administration questionnaires were given to the participants. These surveys included the Subjective Units of Disturbance Scale (SUDS) and the Diagnostic Symptom Questionnaire (DSQ). These studies were modified for use with the DSM-IV definition of a panic attack.

RESULTS: None of the patients who ingested the placebo showed evidence of a clinical panic attack. This was a consistent finding in all three studies. A panic attack was not experienced by any of the control subjects in the 2008 and 2009 studies. Two of the control subjects experienced a panic attack in the 2007 study after ingestion of caffeine. Finally, the panic disorder patients experienced a panic attack at frequencies of 60.7%, 52.0%, and 58.6%, in each of the studies, after administration of 480mg of caffeine.

CONCLUSIONS: All three studies showed sufficient association of ingestion of 480mg of caffeine with the induction of a clinical panic attack those afflicted with panic disorder. Although there is strong evidence showing that ingestion of caffeine in a patient with a panic induces a panic attack, there is no evidence showing that abstinence from this chemical reduces panic attack incidence. This is due to the fact that no credible scientific studies have yet been designed to show this information.