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the book 'Saving Sammy,' OCD and PANDAS

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AardvarkGoodSwimmer
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14 Dec 2013, 4:01 pm

Saving Sammy: Curing the Boy Who Caught OCD, Beth Alison Maloney, 2009.

http://alturl.com/8gauw <--short url to google books.

In her book, Beth Maloney talks about her struggles to get appropriate treatment for her son, who struggled with significant obsessive-compulsive disorder.

Okay, the whole theory with PANDAS, which is controversial, is that some OCD is (indirectly) caused by bacteria. Indirectly, because it's the bodies antibodies to strep which attack the brain's basal ganglia, for the unlucky subset of people who are vulnerable to this. Now, the good news is that with prophylactic antibiotics, this damage is reversible to a considerable extent. And so, this type of OCD can be treated maybe somewhat quicker than other types of OCD. And this is probably just a minority of all causes of OCD.

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus.



ASDMommyASDKid
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14 Dec 2013, 7:08 pm

Admittedly, I do not have a lot of knowledge about this, but I would be nervous about prescribing antibiotics in this way. I thought it was recommended to be more careful about prescribing antibiotics b/c of antibiotic resistant strains that evolve as a result of too much antibiotic use. Would it make the user more apt to get more difficult to treat infections?

(I didn't read the linked article, yet, so I apologize if that was covered.)



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15 Dec 2013, 4:06 pm

I'll just say that OCD is serious enough, that if there's a reasonable chance that it's strep related, I think it's worth taking the chance.

Okay, for a person who has had strep relatively recently, a blood test will show various titer levels of antibodies to strep. However, if the strep is too recent, the antibodies may not have had enough time to form.

A doctor can also do a throat swab for strep although sometimes this misses.

==========

Now again, PANDAS is controversial, and PANS even more so. Here's another website:

https://mghocd.org/ocd_pandas/



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17 Dec 2013, 4:47 pm

The first antibiotic the doctor tried for her son only worked for a while, they tried a series of antibiotics, and then hit upon Augmentin, which seemed to work longer term.

Quote:
Saving Sammy: Curing the Boy Who Caught OCD, Beth Alison Maloney, 2009.

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Page 35:

I was at my desk the following day when I heard loud pounding coming from the second floor. I ran downstairs and screamed. Sammy was banging his head against the sliding glass door.

"Sammy! Stop! Stop!" I yelled.

"I can't!" he sobbed. "It's like a mental itch!"

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Pages 221-22:

Augmentin is an extremely powerful antibiotic that is often prescribed when penicillin is not effective. It is largely composed of penicillin, but it also contains something called clavulanic acid. Clavulanic acid prevents the breakdown of penicillin,; it makes the penicillin more effective. I often wondered why Augmentin had worked for Sammy when so many other powerful antibiotics had failed him.

I started thinking about inflammation in Sammy's brain after I read an article in the New York Times about Alzheimer's and Augmentin. It reported that when a group of Alzheimer's patients were given daily doses of Augmentin, their memories improved. The article quoted experts who theorized the possibility of inflammation in the patients' brains. I also had anecdotal information about elderly patients who made remarkable recoveries when fluid was released from their brains. Perhaps fluid on the brain creates a pressure similar to swelling. The body swelled when it was pounded; why not the brain when assaulted by antibodies? Could this be the "mental itch" that had caused Sammy to bang his head when he first got sick?

Dr. Nicolaides believes there is something to the anti-inflammatory premise. One of her PANDAS patients, who also suffered from asthma, had his OCD symptoms abate when he took prednisone for the asthma. Prednisone is a steroid that is also an anti-inflammatory. As the prednisone was withdrawn, the OCD symptoms returned. This led her to believe that there was inflammation in the basal ganglia. She wondered if perhaps swelling is caused when the antibodies and antigens react.

Okay, so basically, a couple of single patient reports, which are also called anecdotal reports. Plus, the one study in the New York Times about Alzheimer's. Okay, fine. But, I think there are several good ideas here worth exploring further.