Panic disorder and social anxiety disorder subtypes in a caffeine challenge test

Psychiatry Res. 2009 Sep 30;169(2):149-53. doi: 10.1016/j.psychres.2008.06.023. Epub 2009 Aug 20.


Studies have demonstrated the vulnerability of anxiety disorder patients to challenge tests. Our aim was to observe if panic disorder (PD) patients and generalized social anxiety disorder (GSAD) and performance social anxiety disorder (PSAD) patients respond in a similar way to the induction of anxiety symptoms and panic attacks by an oral caffeine challenge test. We compared 28 PD patients, 25 GSAD patients, 19 PSAD, and 26 control subjects after a 480-mg caffeine test. The patients had not received psychotropic drugs for at least a 4-week period. In a randomized double-blind experiment performed in two occasions 7 days apart, 480 mg of caffeine and a caffeine-free solution were administered and anxiety scales were administered before and after each test. A panic attack was induced in 17 (60.7%) PD patients, 4 (16.0%) GSAD patients, and 10 (52.6%) PSAD patients, during the caffeine test. None of the control subjects had a panic attack after the caffeine intake. Neither patients nor any control subject had a panic attack after drinking the caffeine-free solution. Our data suggest that there is an association between PD and PSAD hyperreactivity to an oral caffeine challenge test. The PD and PSAD patients had a higher number of induced panic attacks, some specific anxiety symptoms, and a more severe anxiety response than GSAD patients and normal volunteers.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Caffeine* / adverse effects
  • Central Nervous System Stimulants* / adverse effects
  • Double-Blind Method
  • Humans
  • Middle Aged
  • Panic Disorder / chemically induced*
  • Panic Disorder / diagnosis*
  • Phobic Disorders / chemically induced*
  • Phobic Disorders / diagnosis*
  • Psychiatric Status Rating Scales
  • Social Behavior
  • Surveys and Questionnaires
  • Young Adult


  • Central Nervous System Stimulants
  • Caffeine