Which medication is listed as a potential contributor to anxiety symptoms?

• A. Caffeine
• B. Acetaminophen
• C. Ibuprofen
• D. Diphenhydramine

Answer: (A)

Stimulants that raise arousal levels can worsen or mimic anxiety symptoms. Caffeine does this by blocking adenosine’s calming effects in the brain, which increases neuronal activity and boosts the release of norepinephrine and dopamine. The result is heightened alertness, jitters, tremors, palpitations, and potential sleep disruption—all of which resemble anxiety and can amplify it, especially in sensitive individuals or those with insomnia. Caffeine withdrawal can also produce irritability and headaches that feel like anxiety flares, further linking caffeine to anxiety symptoms.

Acetaminophen and ibuprofen are not CNS stimulants and don’t typically provoke anxiety. Diphenhydramine is mainly sedating and anticholinergic; while it can cause agitation in rare cases, it is generally associated with drowsiness rather than contributing to anxiety as a usual effect.