The Impact of Caffeine in Triggering Panic Attacks among Adults with Panic Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abdulrahman Mohamed Buhiji1,2, Mahmood Ahmed Saleh1,2, Aram Kassim3 , Aayat Ebrahim Faraj1,2, Sara Jaafar Mohamed1,2, Kiara Verhagen3 , Mo’ez Al-Islam Faris4 , Haifa Mohammad Saleh Algahtani2 , Haitham Jahrami*1,

1Ministry of Health, Manama, Bahrain.2College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.3King Hamad University Hospital, Bussaitain, Bahrain. 4Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
*Correspondence Email Address: hjahrami@health.gov.bh

ABSTRACT

Objective: Patients with panic disorder (PD) appear to be at a high-risk for developing a panic attack when consuming caffeine. The purpose of this review was to explore the impact of consumption of caffeine-containing foods in triggering panic attacks among adults diagnosed with PD. Methods: An electronic search of PubMed/Medline and EMBASE databases was conducted. The keywords used for the search were “caffeine”, “energy drink”, “tea”, “coffee”, “caffeinated drinks”, “caffeinated beverages”, “anxiety”, “panic disorder”, ”panic attacks”, and “adenosine receptor agonist”. Studies that reported the experience of caffeine-induced panic attacks among adult patients diagnosed with PD and published in English peer-reviewed journals between January 1950 and December 2018 were included. Each article was reviewed independently by at least two investigators. Panic attacks induced by consuming caffeine-containing foods in PD patients were the primary outcome of interest. Estimates were pooled using random-effects and meta-analysis. Subgroup analysis for sex, age, and country variables was conducted as well. Results: The events of panic attacks among PD patients after caffeine consumption were extracted from fifteen studies across four countries (K=15, N=360). The overall pooled data showed that 48% (173/360 PD patients (95% CI 38.6%–57%) experienced caffeine-triggered panic attacks. Conclusions: In this systematic review and meta- analysis, about half (48%) of adults with PD experienced panic attacks after caffeine consumption. Further research is needed to examine the prevalence of panic attacks on a larger scale among different regions, standardize the dosage of caffeine in the future experiment, as well as identify the potential confounding factors.

Keywords: Anxiety, Caffeine, Energy drink, Tea, Panic attacks, Panic disorder
Citation: Abdulrahman Mohamed Buhiji, Mahmood Ahmed Saleh, Aram Kassim, Aayat Ebrahim Faraj, Sara Jaafar Mohamed, Kiara Verhagen, Mo’ez Al-Islam Faris, Haifa Mohammad Saleh Algahtani, Haitham Jahrami. The Impact of Caffeine in Triggering Panic Attacks among Adults with Panic Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Canadian Journal of Clinical Nutrition 2020; 8 (1): 69-94.
DOI: https://dx.doi.org/10.14206/canad.j.clin.nutr.2020.01.06

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