caffeine and panic disorders

i have found no informationon this topic. I have panic attacks without agraphobia,it is the fear of having the attacks that brings them on.i am on paxil and ativan and am also in counseling,and have also been told that i have ptsd.here is my question. i have had to cut down on the amount of coffee that i drink because i have found that if i have more than 2 cups a day  i get very nervous and shakey (shaky) and before i know it i am in a panic attack. i know that caffeine has these affects on people,but i have never had any problems before. is this all in my head or is this a real thing that is going on.

[HFHS M.D.-SW]

Dear Melissa,

Caffeine is a stimulant, and you may have developed increased
sensitivity to it with time. Caffeine can cause jitteriness, tremulousness, and increased heart rate, all of which can also occur in panic or anxiety. There could also be a psychological component contributing to your anxiety.
I recommend you abstain from caffeine until your anxiety and panic are stable.  Your therapist may recommend some techniques to help you relax and cope better with anxiety provoking stressors.
My best wishes to you.


Sincerely,


HFHS M.D.-SW