In people with panic disorder, panic attacks triggered by caffeine occur without measurable changes in cortisol, ACTH, or DHEAS levels, suggesting these attacks may arise from brain pathways that do not rely on these specific stress hormones.

In people diagnosed with panic disorder, consuming 400 mg of caffeine triggers panic attacks in about half of them, but this reaction does not correspond to higher levels of stress hormones like ACTH, cortisol, or DHEAS compared to those who do not have a panic attack, suggesting the panic response is not driven by activation of the HPA axis.

Caffeine causes similar increases in stress-related hormones in people with panic disorder and in people without it, meaning this hormone response cannot be used to identify panic attacks specifically.

In controlled settings, a 400-mg dose of caffeine triggers panic attacks in about half of people diagnosed with panic disorder, while a placebo does not cause panic attacks in this group.