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Tuesday, 13 October 2009

SDS Delegate Debate: A single session cure for panic attacks?

Dear All

Recently I came across an interesting piece of research, whilst preparing reading materials for our forthcoming seminar on Anxiety. (
As it was a very simple and useful way of helping clients I thought I would share it with you.

We all know that excessive caffeine consumption is probably not the most sensible thing for anxious clients to be doing. However, the question is - what is “excessive” and how un-sensible is it? On one hand, the British Coffee Association states that “scientific evidence consistently shows that drinking up to … four to five cups of coffee a day is perfectly safe … and may confer health benefits.” On the other hand, a paper published last month in Psychiatry Research suggests otherwise and indicates that caffeine consumption alone may be more than sufficient to promote and maintain panic attacks.

In a double blind experiment in Brazil (appropriately enough), of those experiencing panic attacks, nearly two thirds had such an attack after drinking the equivalent of 5 cups of coffee. However in a control group of those who had previously experienced such attacks, not a single panic attack was reported after consuming non-caffeinated drinks. *

As is so often in our field, substance consumption plays an important role. Not just in making problems more complex but also in providing potentially simple solutions.
Next time you work with an anxious client, remember to encourage caffeine elimination before engaging in more complex interventions. It may be sufficient to cure the problem.

We are looking forward to working with you in our future seminars. Remember that our seminar on Anxiety is fully booked on the first day in London, but there are still places left on the second London date and at other venues around the country.

Book online ( and receive automatic £10 discount.

Kind regards
Paul Grantham
Consultant Clinical Psychologist

* References: Panic disorder and social anxiety disorder subtypes in a caffeine challenge test Nardi AE, Lopes FL, Freire RC, Veras AB, Nascimento I, Valença AM, de-Melo-Neto VL, Soares-Filho GL, King AL, Araújo DM, Mezzasalma MA, Rassi A, Zin WA. Psychiatry Res. 2009 Sep 30;169(2):149-53.


  1. Thanks Paul

    In fact I have been recommending this to clients for some time from my own observations of the effects of coffee - chocolate too is not brilliant for a balanced mood as it raises seratonin levels and so there has to be a 'downer' at some point!

    I am looking forward to the Bristol session on Anxiety.


  2. Dear Paul
    Thank you for this interesting information, I will pass it on. I do hope to see you at one of the anxiety management courses soon.
    With best wishes

  3. Hi Paul - thanks ever so much for this info - I am helping year 11 students with practical tips and strategies for managing exam stress and anxiety. I put caffeine consumption on the handout that I prepared for them as it seems that the consumption of Red Bull and other such drinks may be on the rise among secondary school students.
    Thanks again

  4. Hello and thank you for passing this interesting piece of information on to me,


  5. Paul, very interesting, thank you. I work a lot with anxiety and panic (as well as other anxiety disorders, hence looking forward to your anxiety workshop in November!). Checking caffeine consumption is probably a further line to follow when looking at first for the simple solutions.

    So thank you for the info. Always gratefully received!


  6. For past 2 years I have asked any client with anxiety or panic attacks about caffiene (coffee, coke, red bull, and yes Lucozade!) This arose from working with someone who was responding to therapy but still had some symptoms. Almost by chance I discovered he was drinking 12plus mugs of strong coffee per day.Gradual replacement by de-caff suggested. His symptoms then disappeared. Not sure if always about caffiene, or can be about client recognising there are possibilities of recovery and a more hopeful outlook? I find it's still worth asking. K.R.


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