title: Panic disorder and social anxiety disorder subtypes in a caffeine challenge test.
abstract: 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.
authors.affiliation: Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Pirajá, 407/702, Rio de Janeiro, RJ-22410-003 Brazil. antonionardi@terra.com.br
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Nardi
authors.forename: Fabiana L
authors.initials: FL
authors.lastname: Lopes
authors.forename: Rafael C
authors.initials: RC
authors.lastname: Freire
authors.forename: Andre B
authors.initials: AB
authors.lastname: Veras
authors.forename: Isabella
authors.initials: I
authors.lastname: Nascimento
authors.forename: Alexandre M
authors.initials: AM
authors.lastname: Valença
authors.forename: Valfrido L
authors.initials: VL
authors.lastname: de-Melo-Neto
authors.forename: Gastão L
authors.initials: GL
authors.lastname: Soares-Filho
authors.forename: Anna Lucia
authors.initials: AL
authors.lastname: King
authors.forename: Daniele M
authors.initials: DM
authors.lastname: Araújo
authors.forename: Marco A
authors.initials: MA
authors.lastname: Mezzasalma
authors.forename: Arabella
authors.initials: A
authors.lastname: Rassi
authors.forename: Walter A
authors.initials: WA
authors.lastname: Zin
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002110:Caffeine / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D004311:Double-Blind Method; D006801:Humans; D008875:Middle Aged; D016584:Panic Disorder / Q000139:chemically induced* / Q000175:diagnosis*; D010698:Phobic Disorders / Q000139:chemically induced* / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales; D012919:Social Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D002110:Caffeine