PANDAS (cont.)

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What is the treatment for PANDAS?

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PANDAS is treated primarily with cognitive behavioral therapy and medication, depending on the breadth and severity of symptoms. Currently, the primary medical therapy is focused on controlling the OCD symptoms and therefore select selective serotonin reuptake inhibitor (SSRI) medications are frequently used (fluoxetine [Prozac] and others). The other more acute measure in treating PANDAS is treating the strep infection associated with the symptoms. Antibiotics are the treatment of choice to eradicate an active strep throat infection. Your doctor may prescribe penicillin, amoxicillin (Amoxil), azithromycin (Zithromax), or another antibiotic. For severe and refractory symptoms, the use of other treatments aimed at controlling the immune response have been studied and found to be effective. These include the use of intravenous immunoglobulin, steroids, and plasmapharesis (plasma exchange therapy in which blood is withdrawn from an individual and the liquid portion is removed and replaced and the blood is transfused back into the individual). For both treatments, the "offending" antibodies are removed. Steroids are less effective, because, although symptoms decrease during the treatment, they return soon after stopping. More studies are needed to be able to recommend immune-modulating therapies without hesitation.

What is the prognosis of PANDAS?

Though some children completely recover from PANDAS, there are some who develop persistent neuropsychiatric symptoms or develop worsening symptoms after each strep infection. It is not currently possible to predict which children will be affected or how severely. The mainstay of therapy is to decrease the OCD, tics, or other behaviors which might interfere with daily life and school.

Medically Reviewed by a Doctor on 10/28/2013

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