A cautious PSA about PANDAS and rapid onset OCD and anxiety in kids

‘Tis the season of strep throat and norovirus and other infections, and that is bad enough. But some researchers and doctors believe that infections can occasionally trigger a misdirected autoimmune response, especially in children, that causes sudden, alarming psychiatric symptoms: extreme anxiety, OCD, intrusive thoughts including suicidal ideation, tics, sudden difficulty with math and handwriting, and sensory problems.

The illness is called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). A child who’s otherwise healthy develops these symptoms literally overnight, and while the infection that triggered them can be cured, no treatment seems to alleviate the psychiatric symptoms.

I know that not all medical professionals accept PANS/PANDAS as a legitimate diagnosis, and that a lot of very nutty people have latched onto it. I am not a doctor or a scientist. I’m simply a mom passing along information about something that has helped other parents, and that is the entirety of what I know about it. I know three moms — sensible, educated people who accept modern, western medicine, not gullible, fearful, or prone to woo — who had run out of other explanations for their kids’ sudden change in behavior, and got no relief from the normal treatment (therapy, SSRIs). They talked to their doctors about PANS/PANDAS and then gave their kids n-acetyl l-cysteine (NAC), which you can get over the counter. NAC is normally used to prevent asthma attacks and treat rashes, but it truly seems to have cured these kids of their psychological symptoms. 

I am not making any claims about this hypothesized illness or this hypothesized treatment, as I’m not qualified in any way to do so (and I’m certainly not getting any kind of kickback or payment, other than what I normally earn from page views of this site). I’m just passing along what I have heard, because I know how it feels to see a kid suffering and to not know how to help. This is just one more thing to consider.

So if your kid develops anxiety or other inexplicable psychiatric disorders, please don’t immediately assume it’s PANDAS, and please don’t try to treat it without professional help. We have a few kids who suffer with severe anxiety, and it’s not PANDAS. Lots and lots of things can cause psychological symptoms, and sometimes there is more than one cause. But if you and your doctor have tried all kinds of other treatments and nothing is helping, and the kid did have an infection before a very sudden onset of the symptoms, this is something to consider. 

Image: Sherif Salama via Flickr (Creative Commons)