by Dmitry M. Arbuck, M.D.

Commentary written for the Carmel Current paper, Carmel, IN
I want to make a case against caffeine. I don’t want to anger all the Starbucks lovers, but
everybody needs to know that caffeine is one of the major offenders associated with pain,
anxiety, depression and other unwanted problems.
Caffeine actively causes pain by decreasing pain threshold and making the nervous system
more alert to pain. This is why just stopping caffeine may bring some relief in pain.
The same works for anxiety and panic attacks. Multiple patients come to me with huge jars of
caffeinated soft drinks, trembling, and complaining of anxiety and not understanding that their
drink is what makes them sick.
Caffeine causes muscle spasms and muscle twitching. It causes headaches and actively
promotes chronic headaches. Caffeine causes palpitations and increases the frequency of
urination. Caffeine causes tremors and cold hands and feet. Caffeine causes ringing in the
ears and insomnia.
All these symptoms happen not to an innocent extent, but rather robustly, frequently
making lives of people who consume caffeine miserable. No patient with chronic pain or
anxiety of any sort should use caffeinated beverages.
You may be surprised, but caffeine also is associated with depression, because it exhausts the
central nervous system and causes rebound depression as it causes rebound headaches and
rebound pain.
Some medications increase the blood level of caffeine, prolonging its unwanted effects. One
the biggest offenders is the medication fluvoxamine, or Luvox. On the contrary, smoking
decreases the caffeine level. This is why, not infrequently, people who smoke like to drink
coffee, because it produces a euphoric effect without physical unwanted symptoms. Beware of
caffeine, my friends, and abstain from it whenever possible.