Treatment Options

Immunomodulatory Therapies: May be recommended based on the patients needs in order to balance the immune system’s response to pathogens and allergens.

  • Intravenous immunoglobulin (IVIG) may be recommended for severe cases. IVIG can be performed in the hospital or in the home and is an infusion of antibodies collected from healthy donors, similar to a blood transfusion. The antibodies in IVIG can help regulate the immune system to fight chronic infections and reduce autoimmunity. It’s typically used when there is severe symptom onset.

  • Camel Milk is sometimes called the “poor man’s IVIG” because it also contains immunoglobulins that can help modulate the immune system. It’s less likely to cause side effects than IVIG. Camel milk is anti-inflammatory, antimicrobial, contains immunoglobulins that can help fight pathogens, and may help with autoimmune diseases.

  • Classical Homeopathy uses potentized remedies made from plants, animals, minerals, and body substances to treat the totality of physical, emotional, and mental symptoms. Classical homeopathy provides a holistic method of healing that can bring the immune system back into balance and gently nudge the body back to health, mentally, emotionally, and physically.

  • Homeopathic Detox Therapy (HDT) is a healing method and type of homeopathy that uses minuscule amounts of substances, such as Strep, mold, Lyme, and other pathogens or toxins to remove blocks to healing and rebalance the immune system’s inappropriate response to those pathogens. It reeducates the immune system to eliminate excessive overproduction of autoantibodies and balance the immune system’s activity. The treatment targets specific pathogens and toxins and improves immune tolerance.

  • Low Dose Immunotherapy (LDI) is an innovative sublingual approach which involves low doses of the triggering pathogen or antigen and offers hope for long-term relief. LDI is a blending of immunotherapy, as in seen in allergy tolerance therapy, and homeopathy. LDI is designed to gently retrain the dysfunctional immune mediated response by creating tolerance to specific allergens and pathogens (strep, borellia, bartonella, viruses, fungi, parasites) that trigger the autoimmune reaction.

  • Platelet-Rich Plasma (PRP) Therapy, such as the brand TruDose Platelet Therapy, involves using a patient's own blood to extract platelets, which are then concentrated and injected into the body to promote healing. The platelets contain growth factors that stimulate tissue repair, reduce inflammation, and can be used to treat various conditions such as joint pain, tendon injuries, hair loss, and even skin rejuvenation.

  • Plasmapheresis (Plasma Exchange, PEX) is another immunomodulatory therapy which is performed in a hospital setting and can be used to mechanically remove all antibody proteins (including autoantibodies) from a patient’s blood. This is a more invasive procedure that involves removing the patient’s plasma (which may contain harmful antibodies) and replacing it with donor plasma or a synthetic substitute. It may be considered in severe cases, particularly when other treatments have not been effective.

  • Rituximab (Rituxan) is a synthetic antibody (protein) that causes b-cell depletion and can target antigens or substances that can cause an immune response. Rituximab targets and attaches to the CD20 protein found on the surface of cancer cells and healthy blood cells. Rituximab has been involved in cases of diffuse interstitial pneumonia, heart conditions, and may lower the ability of your immune system to fight infections.

  • CellCept (Mycophenolate Mofetil) is an immunosuppressive prescription medication (drug that weakens your immune system) that is sometimes prescribed for PANS/PANDAS. It is typically used to prevent organ rejection in people who have had a transplant. CellCept has a boxed warning for the increased risk of certain cancers, such as lymphoma or skin cancer, as a rare but serious side effect in clinical trials of the drug.

Antimicrobials:

  • Antibiotics: Antibiotics are often prescribed to treat the underlying infections triggering the autoimmune response. Long-term prophylactic antibiotics may be prescribed, however continually suppressing the immune system may cause chronic inflammation and may cause the immune system to become disordered. Many antibiotics have long-term side effects and overuse of antibiotics in patients is contributing to overall bacterial resistance.

  • Antifungals, Antivirals, and Antiparasitic medications: May be prescribed to treat molds, viruses, and parasites triggering PANS/PANDAS. Many medications have long-term side effects and may cause the immune system to become disordered. Use caution when taking any medication.

Palliative Anti-Inflammatory Treatments:

  • Corticosteroids: May be prescribed to reduce inflammation and modulate the immune response. Steroids like low-dose prednisone can help decrease brain inflammation and provide short-term symptom relief, but should not be used for long-term as it can cause immune system suppression and serious side effects.

  • NSAIDs: NSAIDs like Ibuprofen may temporarily reduce inflammation in the event of a PANS/PANDAS flare and can be used to provide short-term relief.

Psychiatric and Neuropsychiatric Medications:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): These medications, commonly used to treat OCD and anxiety disorders, may be prescribed to help manage the psychiatric symptoms associated with PANS/PANDAS. Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and fluvoxamine. SSRIs can cause serious side effects, such as the worsening of anxiety or depression when the medication stops working or when a new episode of depression develops that's not responsive to the medication. 

  • Antipsychotic Medications: In severe cases, antipsychotics such as risperidone or aripiprazole may be used to manage severe tics, aggression, or psychosis.

  • Other Medications: Medications for attention-deficit hyperactivity disorder (ADHD), anxiety, or sleep disturbances may also be prescribed.

Behavioral Therapy and Parenting Support:

  • Cognitive Behavioral Therapy (CBT) is a first-line therapy treatment for OCD and anxiety, which are common in PANS/PANDAS. CBT helps children manage symptoms by changing thought patterns and behaviors. CBT and other forms of psychotherapy can help individuals and families cope with the emotional and behavioral challenges associated with PANS/PANDAS.

  • The Nurtured Heart Approach® focuses on: self-regulation, transforming the way children perceive themselves, their caregivers, and the world around them, teaching children that they will receive recognition through positive behavior, supporting children as they build a positive portfolio of themselves, or “Inner Wealth™”, and seeing intensity to be a powerful quality that, if developed correctly, can drive children to amazing achievements. This approach is a helpful tool for transforming complex children.

  • Eileen Divine parenting workshop focuses on concrete strategies on forming a deeper connection with your challenging child and parenting them in ways that align with their unique brain function.  Neuroscience research shows that the brain and behaviors are always connected, so parenting from a “brain first framework” -- thinking brain first, and then behavior -- our child's challenging behaviors are reduced and we shift toward greater connection and less frustration in our parenting experience.

  • Celebrate Calm parenting workshop and podcast focuses on specific practical strategies to find ways to stop the yelling, defiance, and power struggles and establish ways to build confidence for the parent and child.

  • Occupational and Speech Therapy: These therapies can address sensory and motor challenges that may accompany PANS/PANDAS.

Nutritional Support and Supplements

  • Supplements, such as omega-3 fatty acids, probiotics, and vitamin D, are given to support brain health and immune function. There is some evidence to suggest that these can play a role in improving overall health, though they should be used as adjuncts to other treatments.

  • Dietary changes such as gluten-free or anti-inflammatory diets reduce the overall inflammatory load on the patient’s immune system. Some PANS/PANDAS families have reported improvements with dietary changes.