Acute effects of 150 mg caffeine on subjective, physiological, and behavioral components of anxiety in panic disorder and healthy controls - A randomized placebo-controlled crossover trial.

IF 5.5 3区 医学 Q1 CLINICAL NEUROLOGY
Journal of Psychopharmacology Pub Date : 2025-08-01 Epub Date: 2025-06-27 DOI:10.1177/02698811251344692
Johanna M Hoppe, Johannes Björkstrand, Johan Vegelius, Lisa Klevebrant, Malin Gingnell, Andreas Frick
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引用次数: 0

Abstract

Background: Caffeine in doses above 400 mg, approximately four cups of coffee, induces panic attacks in 50% of individuals with panic disorder (PD) and elevates anxiety, but it is not known how individuals with PD respond to normally consumed doses or how caffeine interacts with emotional tasks.

Aims: We hypothesized that 150 mg caffeine would increase subjective anxiety (primary outcome) as well as interoceptive attention and anxiety from bodily signals in patients with PD, and more so than in healthy controls (HCs). Additional analyses targeted panic attacks, emotional reactivity, avoidance behavior, and subjective exteroceptive attention.

Methods: Twenty-nine patients with PD and 53 HC with low habitual caffeine consumption (⩽300 mg/week) abstained from caffeine 36 h before receiving 150 mg caffeine or placebo in a double-blind randomized crossover design 2-14 days apart.

Results: Contrary to our hypotheses, caffeine did not increase subjective anxiety, interoceptive attention, or anxiety from interoceptive signals. Only one panic attack was noted, in the PD group after caffeine intake during the emotional reactivity task. In both PD and HC, caffeine increased skin conductance responses to neutral and emotional faces, augmented costly avoidance behavior, and impaired exteroceptive attention. These results indicate that low caffeine doses do not have differential anxiogenic effects in patients with PD and HC at rest, and that they increase arousal and avoidance behavior in both PD and healthy individuals.

Conclusions: In conclusion, we suggest that recommendations for caffeine abstinence for patients with PD should be based on higher doses and ideally on individual assessments.

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150毫克咖啡因对恐慌症患者和健康对照者焦虑的主观、生理和行为成分的急性影响——一项随机安慰剂对照交叉试验
背景:咖啡因的剂量超过400毫克,大约四杯咖啡,会引起50%的惊恐障碍(PD)患者的恐慌发作,并加剧焦虑,但目前尚不清楚PD患者对正常摄入剂量的反应,也不知道咖啡因如何与情绪任务相互作用。目的:我们假设150mg咖啡因会增加PD患者的主观焦虑(主要结局)以及身体信号的内感受性注意和焦虑,并且比健康对照组(hc)更明显。额外的分析针对恐慌发作、情绪反应、回避行为和主观的外感注意。方法:29例PD患者和53例HC患者在接受150mg咖啡因或安慰剂治疗前36小时戒掉咖啡因(≤300 mg/周),采用双盲随机交叉设计,间隔2-14天。结果:与我们的假设相反,咖啡因不会增加主观焦虑、内感受性注意力或内感受性信号的焦虑。在PD组中,在情绪反应任务中摄入咖啡因后,只注意到一次恐慌发作。在PD和HC中,咖啡因增加了对中性和情绪化面孔的皮肤电导反应,增强了昂贵的回避行为,并损害了外感受性注意。这些结果表明,低剂量咖啡因在PD和HC患者休息时没有不同的焦虑效应,它们增加了PD和健康个体的唤醒和回避行为。结论:总之,我们建议帕金森病患者戒断咖啡因的建议应该基于更高的剂量,最好是基于个人评估。
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来源期刊
Journal of Psychopharmacology
Journal of Psychopharmacology 医学-精神病学
CiteScore
8.60
自引率
4.90%
发文量
126
审稿时长
3-8 weeks
期刊介绍: The Journal of Psychopharmacology is a fully peer-reviewed, international journal that publishes original research and review articles on preclinical and clinical aspects of psychopharmacology. The journal provides an essential forum for researchers and practicing clinicians on the effects of drugs on animal and human behavior, and the mechanisms underlying these effects. The Journal of Psychopharmacology is truly international in scope and readership.
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