Guest guest Posted June 14, 2012 Report Share Posted June 14, 2012 Hi I too have a 7 yr old with OCD and she has anger outbursts as well. Does anyone know why there is an anger piece to this? That is worse than the actual OCD Sent from my iPhone > Hi, my 6 yr old has OCD which is terribly worsened by PANS! > He is on antibiotics long term also clonidine and > Melatonin to sleep and ibuprofren seems to help > During the day with his anger outbursts. I can't > Stand watching him suffer with constant obsessive > Thoughts and I wanted to know if anyone else > Has there child with PANS or PANDAS on an ssri. > I always just expected he would need Prozac > ( like my husband and myself) to control the OCD but > Now it's complicated by the PANS. I've read that > Ssris can make PANS worse. Please help, any advice > Or experiences with this would be greatly appreciated. > Thanks, debbie > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2012 Report Share Posted June 14, 2012 Is the anger only in relation to when she can't perform her compulsions or avoid what she might have anxiety about, or is she raging for indiscriminate reasons? Temper with regard to OCD should only occur if the person feels tremendous anxiety and wants you not to get in the way of her/him doing what they feels is needed to relieve this. On the other hand, just because someone with OCD has a tantrum, doesn't mean you should allow it. There should be consequences for bad behavior or else you are going to wind up with two problems: how to help the OCD and how to unlearn the concept that raging gets what is wanted. Thus, the best thing is to get help from an OCD professional and have your child understand what OCD is and why it's best not to give into it. Most kids seem to do well with naming their OCD something like " bully " or 'Crazy guy " or something. They then work with the professional to make a list of which fears and resulting rituals/compulsions will be worked on. If your child is working on this, then it may be preferred to allow the rituals higher on the hierarchy while he/she is working her way up. Also, with many with OCD, medication may be necessary if the fears seem so real that the exposures and response prevention doesn't work because she can't go along with it. For me and my kids, it has always been medication that allowed for this. Re: PANS ssri question Hi I too have a 7 yr old with OCD and she has anger outbursts as well. Does anyone know why there is an anger piece to this? That is worse than the actual OCD Sent from my iPhone > Hi, my 6 yr old has OCD which is terribly worsened by PANS! > He is on antibiotics long term also clonidine and > Melatonin to sleep and ibuprofren seems to help > During the day with his anger outbursts. I can't > Stand watching him suffer with constant obsessive > Thoughts and I wanted to know if anyone else > Has there child with PANS or PANDAS on an ssri. > I always just expected he would need Prozac > ( like my husband and myself) to control the OCD but > Now it's complicated by the PANS. I've read that > Ssris can make PANS worse. Please help, any advice > Or experiences with this would be greatly appreciated. > Thanks, debbie > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2012 Report Share Posted June 14, 2012 Hi Debbie, I have no experience with this, but just wanted to offer what I've read from others. From what I understand, an ssri can be added at some point, but after the antibiotics have had a chance to do their job. Think certain time line, so you can see full effect of antibiotics, perhaps. Then ssri is added if needed, to do ERP, for remaining O/C. I seem to recall one parent saying they added an ssri because the anxiety was so high, low dose, while still in the initial stages of antibiotics. Probably one of those things you just have to try and see. I can tell you that I think our son may have a PANDAS?PANS component, overnight severe onset, was a strep carrier, other stuff... He was really med sensitive at the outset too. He was ok on the lowest dose of ssri, and still is. Got into big problems on higher doses. So, talk with your doctor, maybe trying a very low dose might be something to try for some relief, since the antibiotics can take quite a while for some. Hopefully others " in the know " will jump in soon. Warmly, Barb > > Hi, my 6 yr old has OCD which is terribly worsened by PANS! > He is on antibiotics long term also clonidine and > Melatonin to sleep and ibuprofren seems to help > During the day with his anger outbursts. I can't > Stand watching him suffer with constant obsessive > Thoughts and I wanted to know if anyone else > Has there child with PANS or PANDAS on an ssri. > I always just expected he would need Prozac > ( like my husband and myself) to control the OCD but > Now it's complicated by the PANS. I've read that > Ssris can make PANS worse. Please help, any advice > Or experiences with this would be greatly appreciated. > Thanks, debbie > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2012 Report Share Posted June 14, 2012 Children with PANS/PANDAS can be on an SSRI. As with any SSRI, you take the lowest dose that is effective. Generally we read that low doses work best with PANS/PANDAS. But as with any person with OCD, you're going to trial the doses and find the most effective (go too high, get unwanted effect, than lower dose back...). I think with PANS/PANDAS, its more " behavioral " with too high a dose of SSRI for them, so something you'd be sure to notice. But even non-PANS children can have effects like that. Sooo...guessing you'd just trial the low dose for a while, not work up on the dosage at the pace a non-PANS child would. If you've just begun an antibiotic/meds with him, you probably want to wait (hard I know) to give those time to work, see how much relief he gets. Adding another med too soon, you won't know which is working (are the first starting to take effect, or is it the 2nd helping...). If he's been on his current combo a while, then, sure, ask about an OCD med. There are PANS/PANDAS kids who do take SSRIs and benefit from them. Therapy - copied from the OCDF website info: For many PANS children, the suddenness of onset and the migratory nature of the obsessions/compulsions can make Exposure and Response Prevention therapy or ERP challenging; however, a combination of a medical intervention and traditional ERP might be the best course of action at this point in time. For some children an initial treatment with antibiotics or IVIG results in significant relief of symptoms. For those with slow or partial remission of symptoms, ensuring that ERP is included seems to be critical. Children develop habits and fears quickly and they may use ERP treatment to teach their brain to ignore the irrational fear signals they have been receiving. ERP teaches a child concrete tools to overcome OCD thoughts on a daily basis. Many clinicians find that learning ERP allows the entire family to function more calmly during future exacerbations, while seeking medical help. Some recent but preliminary work by a group at University of South Florida found strong effects for this approach in children with PANDAS (Drs. Storch & ). Hang in there, things will get better! It's hard waiting though! > > Hi, my 6 yr old has OCD which is terribly worsened by PANS! > He is on antibiotics long term also clonidine and > Melatonin to sleep and ibuprofren seems to help > During the day with his anger outbursts. I can't > Stand watching him suffer with constant obsessive > Thoughts and I wanted to know if anyone else > Has there child with PANS or PANDAS on an ssri. > I always just expected he would need Prozac > ( like my husband and myself) to control the OCD but > Now it's complicated by the PANS. I've read that > Ssris can make PANS worse. Please help, any advice > Or experiences with this would be greatly appreciated. > Thanks, debbie > Quote Link to comment Share on other sites More sharing options...
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