http://www.abc.net.au/rn/allinthemin...06/1789076.htm

Rituals, checking the stove, repetitive thoughts. Everyday patterns for all of us, but when they go awry, the impact of these imps of the mind is devastating and life-consuming. This week, a provocative theory with new, convincing science - could Obsessive Compulsive Disorder in some children be triggered by a common bout of strep throat? And, nipping the obsessions and compulsions in the bud - one parent's story, and a pilot project already changing the lives of young people plagued by OCD.



Transcripts go up on Thursdays after the program is first broadcast. Some relevant links and references below. Audio published on Saturdays.
Guests

Susan Swedo
Senior investigator
Head, Paediatrics and Developmental Neuropsychiatry branch.
National Institute of Mental Health
http://neuroscience.nih.gov/Lab.asp?Org_ID=448

David Castle
Professor of Psychiatry
University of Melbourne
St Vincent's Hospital
http://www.psychiatry.unimelb.edu.au/

Kathryn I'Anson
Director
Anxiety Recovery Centre (ARCVic)
Melbourne, Australia
http://www.arcvic.com.au/

Mother
of a teenage daughter diagnosed with OCD
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Having been hurtfully and wrongly accused of 'spamming' before i would like to point out that none of the informational posts i make are spam.

Any person making such an accusation will automatically be added to my ignore list.

firemonkey who used to post as dyslimbic

welcome back

As I was reading the original post, I took notice of a Podcast about how strep throat may trigger OCD in children. I wonder if it can't happen in adults as well? The reason being that I just got over a bout of strep throat and it seemed that my OCD hit me particularly hard while I was sick. I don't know if it was just due to the stress of being sick (as OCD tends to be worse during times of stress) or if the actual strep had something to do with it.

Any thoughts on this?

Hi there.
From what I know, the researchers have tended to study children rather than adults. PANDAS means Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

I'll post you what I have saved about this issue in adults. I think most are about actual adult onset though, rather than exacerbation. I'm sure there are probably more. I'm a little disheartened by the lack of results coming from the researchers in more recent years about PANDAS. It all seems to have come to a dead end with everything up in the air.

A lot of people will describe as you did an exacerbation of symptoms of tics and/or OCD after or during an illness (GABHS or otherwise). Some people find that while they're really ill with it at first, their symptoms actually decrease, esp. if fever is involved, but then as they begin to recover, the symptoms come out more but then level out again.

The most important thing is that you were treated correctly for the actual Strep. infection at the time. Hopefully your symptoms settled down now after you've recovered from the Strep.??

http://intramural.nimh.nih.gov/pdn/web.htm
NIH - PANDAS

http://ajp.psychiatryonline.org/cgi/...full/159/2/320
Letter to the Editor
Antistreptolysin-O Titers: Implications for Adult PANDAS
ANDREW J. CHURCH, B.SC. and RUSSELL C. DALE, M.B.CH.B., M.R.C.P.
London, U.K.

Link to PubMed Abstract
Bodner SM, Morshed SA, Peterson BS.
The question of PANDAS in adults.
Biol Psychiatry. 2001 May 1;49(9):807-10
http://www.indianjpsychiatry.org/art...aulast=Andrade
Andrade C, Pfizer N.
Sore throat and obsessions: A causal link?.
Indian J Psychiatry 2006;48:130-131

Hi Lara,

Thank you for all this information! You know, my OCD wasn't actually that bad when I was in the fever stage of the illness (I didn't have the sore throat yet). However, I had the strep for about 2 weeks before I was diagnosed with it. I had a really horrible anxiety attack about 3 days before I went to the emergency room to get my sore throat checked out. And actually, the OCD continued to be quite bad while I was on the antibiotics (I just finished all of the medication today). I am finally starting to feel better (the therapy is definitely helping with that). I almost felt as if I was going out of my mind with this bout of OCD (it was a particularly frightening obsession). But now the symptoms are abating.

Thanks again for the useful info!

Hi

just wanted to add that there is a lot of anecdotal evidence suggesting that azithromycin/zithromax may be the antibiotic to be used for PANDAS, as is being documented by parents who have seen dramatic results in reduction of strep antibody titres as well as the symptomatic tics, OCD and general malaise and behavioural problems that seem so characteristic of PANDAS patients

not only does it appear to be best at eradicating the "stealth" strep, but also it seems it has immuno-regulating properties that help in the onslaught that strep wages on the immune system and the resultant "auto-immune" reaction that is believed may be involved in PANDAS

I havent seen any documentation, scientific or anecdotal, on adult onset PANDAS equivalent illness/OCD etc

Severe Adult Pandas?

- Response from Miroslav Kovacevic, MD FAAP
Cl. Asst.Professor of Pediatrics
Loyola University Stritch School of Medicine
Lecturer
University of Illinois at Chicago College of Medicine

Dr. Murphy,

I'm a 29 yr. male, diagnosed with TS at 16. Initial OCD/TS symptoms at age 16 were acute in onset, although I did have significant obsessional symptoms, as early as 13. I have had a fairly regular occurrence of Strep A infections, since childhood. These were sometimes found, according to my mother, to be asymptomatic.
Predominant concerns have been pronounced anxiety, including debilitating OCD. For about eight months, up until three weeks ago, I was doing well, upon initiation of memantine treatment, receiving ~90% in first year, university biology.

Four weeks ago, however, I got a sore throat. Building up to the third day of throat irritation, my OCD returned in full force. I was treated that day, with Penicillin, which seemed to diminish the symptoms in about four days. I did not manage to complete the full course of treatment. At this time I had heart palpitations, and fainting sensations, that ended in an ER visit. Two weeks, after Penicillin treatment, the sore throat returned, with the TS/OCD and Paranoia. I was promptly treated with a more potent antibiotic, which seemed to clear the sore throat.

At present, two weeks later, the OCD remains. It's tormenting, and incapacitating. Particularily, the compulsion to raise my hands in public to embarass myself. I dread being around people, but feel I will die if I don't force myself to do socially inappropriate things, to show people how depraved I am, for a sense of atonement. Obsessions are religious and symmetrical in nature. Extreme emotional lability; one minute I’m o.k., and the next, quite troubled and depressed.

Reading different lists of PANDAS criteria, I seem to fit the majority of them. Could IVIG treatment be a viable option, in your opinion? I am Canadian, but would go anywhere for treatment.

Thank you




Re: Severe Adult PANDAS case?‏

Even though I am fairly convinced that existence of PANDAS AFTER puberty is VERY likely, there is nothing in medical literature addressing it. However, I have seen several patients AFTER puberty developing anxiety attacks, depressive episodes, extreme moodiness that I was able to connect to Streptococcal autoimmune response. In these patients (I have now a group of FOUR) an excellent response was elicited by use of Augmentin. The problem that I have faced is that I still don't know HOW LONG these patients should remain on Augmentin.

I can relate to this. I wish that the torment could be treated. BF