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.