MomWithOCDSon

Have you had any professional opinions or ideas about what microbe or pathogen she may be reacting to in her PITANDS? That usually sets the stage for which class of abx is appropriate to the task. My DS has been taking Augmentin from the start, frankly, based largely on the successful intervention granted by virtue of it to Sammy Maloney of "Saving Sammy" fame. Augmentin is in the beta-lactam abx class, which work by inhibiting the bacteria's cell wall synthesis. Augmentin is considered a broad spectrum beta-lactam abx and shares the class with a whole host of penicillin-derived meds. Penicillins are noted as appropriate for strep and lymes. Cipro, meanwhile, is a quinolone, which works by inhibiting the bacteria's DNA and thus stops replication. Cipro is commonly used for mycoplasmal infections, so is your child, perhaps, diagnosed with something like myco pneumonea?

We tried tenex (Intuniv) for our DS's ADHD-type PANDAS behavior. Initially, we all thought we saw some good impacts on his ability to pay attention, sit still, etc. But long term, the effects seemed to wane, and like you, we just weren't willing to increase the dose to see if the positive impacts would return. And it did lower his blood pressure measurably, too, though we did not see any tics as a result of it. What we came to realize with our DS after a lot of trial and error, but it took a lot of push-back from us with his dox, is that the anxiety/OCD is primary to his PANDAS symptomology, and once the anxiety is under better control, ALL the comorbid behaviors -- ADHD, PDD, etc. -- fade away. So we kept pushing at treating the anxiety first and foremost, rather than those ancillary pieces. You say that abx has not helped . . . just worrying what you've been trying and for how long? I'm sorry, I can't remember your particular story. Have you tried any other interventions for the anxiety/OCD? We really feel we've gotten some very real support from a glutamate-modulating mood stabilizer, lamictal. Don't know if that'd be something you'd be willing to try, but FWIW. Feel free to PM if you'd like to trade some more info; don't want to go on too long here lest I begin to sound like a broken record, since I post fairly regularly!

I like the idea of a "Pinned Threads" success stories, also. It'd be great if a few of the "old-timers" would return to post and re-inspire both newbies and those of us whose upward climb has been a little more extended!

Welcome, Sheila! Yes, unfortunately, finding the "culprit" is one thing; finding the right intervention/response is another. But you're on your way, and there's a big group here to support you! Hoping the azith "does it's thing" for your DD!

All 10 fingers and toes are crossed for you! We can all use a little luck, a little grace, a little Divine Kindness now and again!

Thanks, LLM. Based on your recommendation, DS and I have been taking milk thistle for the last couple of weeks. I do think I'm feeling better, and it may be pure coincidence . . . or a combination of this therapy along with everything else we've been after . . . but DS is actually doing better now than he's done in the last two years. Curious, though, if you've read papers or been given guidance from a professional regarding an appropriate dosage? DS and I are just taking one, 175 mg. capsule daily. It's noted as containing 80% silymarin, which I understand to be the active ingredient. Just wondering if we should be taking more (or possibly less, though what I've found thus far suggests no discernable threat of toxicity)?

Sheila -- Sorry your DD is suffering, but so glad you've found at least one of the likely underlying causes! We felt the same way when we first discovered the asymptomatic strep! It was as though the light bulb went on after months of being in darkness! My fingers are crossed for you, also! Please keep us posted. And now that you know you're members of a "new club," you might want to check into the PANDAS forum when you have questions, as well as this OCD forum. All the best to you and your DD!

How, exactly, does a service animal help with OCD? I've seen in our house how having a pet can provide some opportunity for ERP, especially in confronting contamination. But I'm thinking there must be something more to it for service animals to actually be trained along these lines. Do you have a link or a video or something for more information along these lines? Thanks!

Our DS has suffered a similar form of OCD. He had a fear of alcohol, and he began to fear that any drink in front of him . . . whether we prepared it for him, or we were at a restaurant, or even if he poured it for himself . . . somehow had alcohol in it. And that drinking it would be bad, less because it could harm him, but because "underage drinking is bad" (another form of OCD: scrupulosity). These fears didn't go away on their own. He's taking abx, along with a low dose SSRI (Zoloft) and a low dose mood stabilizer/glutamate-modulating agent, lamictal. Even with all of that support, I don't think the fear would have entirely disipated on its own. We also met it (and continue to meet it) with exposure response prevention (ERP) therapy. Our DS is older than your DD, so the techniques would likely differ, but he created his own "loop tape" on his Iphone, recording his fear ("I'm afraid I'm going to accidentally drink alcohol.") and then listening to it over and over again until he felt less anxious at the thought itself. It sounds as though your daughter is afraid of ingesting something dangerous or just all-out inedible; do you know if it's because she's afraid it will harm her, or if it's just that she knows it would be "wrong" to eat it, and she's afraid of doing something wrong? Once you've divined the real fear, then you or her therapist might be able to design some ERP exercises to meet that fear and help her "normalize" those outsized anxious feelings. I'm sorry I don't have any specific ideas for exercises on hand; I lack the depth of experience for dealing with different fears at different ages, to some degree. Perhaps someone else here will having something to add, but hopefully you have a good therapist on your team who can jump in here, too! All the best!

I don't think that's ignorance . . . it's the same question many of us have been asking ourselves, our doctors, and the researchers for years now. There are lots of theories, but no one seems to know the final "answers," and it may very well be that there is no one answer appropriate to each situation. The meds, the patient, etc., all those variables could result in a different answer for each person. You ask, if the strep is hiding, wouldn't long-term antibiotics kill it? Perhaps, ordinarily. But there might be a few instances in which that doesn't happen effectively: 1) it is a strain of strep that is resistent to the particular antibiotic that's being taken, and/or 2) the strep has gone "intracellular" (there've been a few discussions here on the forum along these lines -- you can search the term) and is therefore much harder to eradicate, and/or 3) the strep or other pathogen is being protected by a "biofilm" which renders it more impervious to the antibiotics (another topic of discussion here on the forum, with a very recent posting by LLM with a long, detailed paper on the topic). You also ask if the antibiotic is perhaps helping with something else besides the strep itself. In our opinion and experience, the answer is "yes," though it isn't necessarily the case for everyone, perhaps. Different classes of antibiotics are thought to have some additional properties that may help our kids. For example, macrolides (azith is one of this class) are thought to have anti-inflammatory properties. Meanwhile, beta-lactam antibiotics (Augmentin is in this class) are thought to have glutamate-modulating properties. Both anecdotally and through some studies (of kids with OCD), inhibiting inflammation and glutamatergic activity seems to assist kids behaviorally. My DS14 has been taking Augmentin XR for nearly two years now. We've tried taking him off and even decreasing the dosage at least a half-dozen times over the last two years. His response, however, has been like clockwork; we begin to see some increased anxiety and hints of returning OCD behaviors within 4 or 5 days, and by Day 8 off the abx, the decompensation is fully palpable. It's happened over and over again, and it seems unlikely that it's due to re-exposure or some other singular strep-related event (he's asymptomatic, so throat cultures always come back negative -- it's only titer tests that reveal an atypical reaction to strep. Is he contending with a lot of intracellular strep or tough biofilms because he went for so many years without treatment, so he needs the abx longer and more continually to meet that strep head-on? Or is he benefitting from the glutamatergic qualities of the abx? Or is it a combination of both? We don't know. And we will probably try reducing the abx again ourselves this summer, once he's settled into his summer routine and we're fairly certain we can tell the difference between his "standard anxiety" over starting something new (like summer school) and any increase in his behaviors not attributable to challenging external circumstances. So, in short, I wish I knew. Or I wish SOMEBODY knew for sure. Meanwhile, we feel compelled to follow our guts, our experience, and our opportunity for feedback and help!

Augmentin is amoxicillin plus clavulanic acid, which is supposed to "boost" the bacteria-busting properties of the amoxicillin. I suppose it's possible, however, that, say, a 500 mg. dose of amoxicillin versus a 500 mg. dose of Augmentin could have differing efficacies because the 500 mg. of Augmentin is going to inherently contain less than 500 mg. of amoxicillin in order to make room for the clav acid piece. So maybe your child needs a higher dose of Augmentin than was required of amoxicillin?

Okay, finally just got through this paper yesterday . . . dense and LOTS of information. Something resonated for us in it, and could go a long way toward explaining our Asymptomatic Strep-Child! Anyone else get a wake-up call from the section about otitis medea? Someone else here on the forum some time ago had posted a link to a French study regarding otitis medea and strep colonization, and now here's documentation regarding biofilm in the middle ear of kids with chronic otitis medea. Our DS had chronic otitis medea from the age of about 14 months until he turned three and we finally "bit the bullet" and submitted him for the tympanostomy (ear tubes) to facilitate more effective drainage. So, via the French study, it seems entirely possible that he harbored strep in his ears (though not, classically, in his throat), and via this paper, the strep may have been further protected and harbored by biofilm. Egad! What our doctors DON'T know could fill a full set of encyclopedias!

Sheila -- Sorry your DD is going through all this. My DS (he's now 14) also has scrupulosity OCD, and therapy is definitely a great tool to help your DD content with that, as well as the sexual thoughts. As for your DD's other potential underlying issues (tics, tourettes, etc.), a pediatric neurologist is probably a good step to take. And finally, I note that you mention that your DD has never had strep throat or Lyme, but I can tell you from personal experience that, just because your child hasn't displayed classic symptoms of strep throat, that doesn't mean she's been entirely spared it, especially during her school years. My DS was diagnosed with OCD at 6 (first grade); it was fairly manageable via therapy and medication for the next 6 years. But then, when he turned 12, his OCD went through the roof to the extent that he was entirely non-functional. He couldn't attend school, he couldn't leave the house, he ritualized nonstop. My DS had never had strep throat that we knew of, but we knew he'd been exposed because we'd get a notice home from school that one of his classmates had been diagnosed with strep, and though he'd never show any sign of it, either DH or I would come down with a classic case within 5 to 10 days. I came across the book "Saving Sammy" shortly after we'd had to pull DS out of school in the 7th grade due to his extreme anxiety and OCD; that book was the first information I'd had that a kid could be completely asymptomatic for strep, but still be suffering from it. We convinced DS's doctor to order the ASO and AntiDnase-B blood tests which measure the level of strep antibodies in the blood stream; this kid who'd NEVER "had strep" was actually walking around with strep antibodies in his system at a level FIVE TIMES the high end of the normal range! He's hyper-immune, so he doesn't get strep in the classic sense, but his body is reacting nonetheless. He was diagnosed with PANDAS, and his OCD behaviors receded dramatically within a week of beginning antibiotic therapy (Augmentin). So . . . not to say that your DD has PANDAS, but just to say it's probably best not to dismiss the possibility just because your DD hasn't displayed classic symptoms. Should you think there's a possibility that your DD has been exposed to strep and therefore that could play a role, you might try giving your DD ibuprofen (anti-inflammatory) and see if she feels at all less anxious or less driven by the OCD thoughts. If she responds at all positively to the ibuprofen, that could be a sign that some inflammation is playing a role in her behaviors and could, in turn, suggest that an inflammatory auto-immune issue is also a possibility. Good luck to you!

We're doing pretty well, thanks for asking. Our doctor is reluctant to go to off-label use of the glutamatergic agents like namenda or riluzole, but we are trying a mood stabilizer, lamictal, which is also thought to have a glutamate-modulating effect. Knock on wood, so far so good, and getting better. He's probably 85% overall and functions well at school and in public. But we continue to "poke the bear" at home and in therapy sessions, trying to get at those lingering OCD anxieties. We continue to do pretty intense ERP for that; even as we speak, DS is speaking "fears" into his Iphone, creating his own "loop tape" to listen to and hopefully therefore decrease his anxiety over those fears. (Right now it's about alcohol consumption . . . mine and DH's, specifically, and the chance of "accidental consumption" on his own part! Guess I don't have to worry about him being convinced by his peers that a couple of beers won't do him any harm! A dubious benefit to all this, I suppose.) Again, so glad to hear you're getting good results now, and I'll look forward to hearing how your DS progresses.

Joan -- Thanks so much for the update! I've been thinking about you and your DS and hoping you were consumed with happy, healthy things while you were away from the forum. So glad to hear he's on a good path! I'm with you in terms of finding that a combination of interventions and strategies might have the greatest overall efficacy, perhaps especially for our older kids like your DS and mine. And interestingly, we, too, have found that 75 mg. of Zoloft seems to be the "magic" level. I am intrigued with what you've seen in terms of what Namenda has done for your DS, if it's possible to tease apart its impact from the Zoloft, Zyprexa and therapy. Could you see an immediate difference? Or was it more gradual? All the best to you!

Hi! I can relate to your husband's fears, and it's even possible that, at first, you'll both think they've been realized. CBT for OCD isn't easy, and especially when the sufferer is in denial about it, being asked to confront the fears and anxieties can stir them up some and roil the waters. But here's the thing: the therapy won't create NEW fears or anxieties. It's only bringing to the surface the ones that already exist. And especially for an older child, abx can make a tremendous difference in their functionality, but therapy can help take her the rest of the way. My DS is now 14; he had been diagnosed with OCD at 6, and it wasn't until his OCD grew to unmanageable levels at age 12 that we found PANDAS and discovered that he's "allergic to strep," among other OCD triggers. Abx helped him when all the traditional OCD interventions (both pharmacological and therapeutic) couldn't make a dent in his anxiety or behaviors. But as he's healed and become healthier, the therapy is helping to give him and us the tools we need for conquering the rest of the OCD that could possible hold him back if we don't address it. Unfortunately, while the OCD may be triggered by microbes and/or pathogens, the behaviors can become learned and/or habitual over time, and people can come to be married to rituals and/or compulsions that they truly believe help them manage the anxiety. But OCD's insidious and a major trickster, and those rituals and compulsions, if not dealt with, can grow and expand and consume more and more of a person's time and space. And, unfortunately, I think for older kids that can be more the case than for younger ones because they have more intellectual capacity and experience at their disposal, so they can better rationalize to themselves and to you why it "makes sense" to touch the doorknob 3 times before leaving the room. I would keep the therapy appointment, and I would express your/your husband's concerns with the therapist up front; let her know how you're feeling and what you hope to accomplish and what you hope to avoid. It may be your daughter's therapy, but you and your DH will be heavily involved, especially in working toward the best possible outcome, so your concerns need to be addressed. As for your DH, yes, perhaps giving him some more information about OCD and OCD and kids would be helpful. The IOCDF web site is a good place to start: International OCD Foundation Also, the Chicago Chapter of the IOCDF has some great, short papers on specific OCD topics called "Expert Perspectives;" some other chapters may have resources like this, too, but the Chicago site is the one I'm familiar with. Papers here like "What is Obsessive Slowness" and other topics that specifically spoke to our son's behaviors not only gave us more information, but also provided us with some resources we could share with his teachers, his grandparents, etc. that could help them understand a little better what he's going through. Since your daughter is tending to deny her OCD, one or more of these papers might break through to her, as well; I know my DS was surprised to read some things that described him so well, even though he'd never met the author or thought that any of the stuff that bothered him, bothered anyone else. Expert Perspectives And finally, Dr. Eric Storch of the Rothman Center for Pediatric Neuropsychiatry at the University of South Florida (he works with Dr. Tanya Murphy, who's well known in PANDAS circles, as well) has authored a number of papers on pediatric OCD, and there's one in particular titled "Family Accommodation in Pediatric Obsessive-Compulsive Disorder" that speaks specifically to the importance of parents getting onboard with therapy for the best outcome. I could only find a link to an abstract of that paper for now, but I believe that if you poke around on the USF web site, you might be able to find a full copy of that paper, as well as a number of other specific to pediatric OCD. You can also PM me with an email address, if you like, and I'd be happy to forward you a copy of the full paper that I have. Family Accommodation in Pediatric Obsessive-Compulsive Disorder - Abstract Honestly, especially since your DD is entering puberty, therapy will be really great for her in the long run, if potentially a little bumpy in the beginning. With our DS now 14, I don't know where we would be today if not for a combination of all the interventions available to us, including abx, therapy, and this forum! Take care, and good luck!

Hi -- What you're seeing might be what many of us call "saw-toothed healing pattern," and yes, it is common for many of our PANDAS kids. If, however, you don't see a return to healthier behavior in the next few days, you may want to check with your doctor about a change in abx. Make sure you chart or journal your child's behaviors daily, even if it's just basic shorthand notes, up and down arrows, etc. That way, before you decide for sure that some change is warranted, you can take a look through the full body of notes and see what the overall trajectory really is. If it's two steps forward and one step back, you're probably okay and heading in the right direction with the right intervention. But if, after many good days, you hit a bad one and the bad ones just keep rolling, one after another, without abatement, then you'll know for sure. FWIW, when we first started abx, the positive changes were so fast, and so dramatic, we sort of got "tricked" into expecting the healing trajectory to continue on that dramatic incline. But it didn't, and it probably wasn't appropriate to expect it to. Maybe he was so bad off when we began, that any relief felt like monstrous relief, know what I mean? When he plateaued the first time, we took him off the abx, thinking maybe it'd done all it could do; within 8 days, though, his behaviors got dramatically worse again, and once again improved when we re-instated the abx. He's continued to improve over time . . . but it's been a long time: almost 2 years now. So, I personally think time is part of the formula here, too. When our kids seem to "go crazy" almost overnight, we want the healing to occur just as instantaneously. Perhaps for some, whose PANDAS gets caught quickly and receive treatment early, the healing is quick. In our experience, unfortunately, it's a longer road.

Cognitive behavior therapy (CBT) can be very helpful for anxiety; you need to know going in, however, that it's not a "quick fix." It's more about giving your daughter (and to some extent, you, also) some life-long tools for successfully addressing her anxiety if and when it should crop up again, as well as helping her now. Supplements that have helped our DS's anxiety level have included NAC and Valerian root, both available over the counter. Once again, though, the NAC takes time because it is a glutamatergic agent that helps quell the impact of excitatory proteins (like glutamate) in the brain. So it's assistance grows over time with the supplement and is not typically immediate. The Valerian root, meanwhile, can help more immediately; we used to give our DS one in the morning with breakfast, before school, and that seemed to help him walk through the school doors. And finally, if you're not categorically against considering "psych meds," some of our kids have been helped through the worst of their anxiety with low-dose selective serotonin reuptake inhibitors (SSRIs). I know many families don't want to go this route, but when your kid is so anxious that they're having trouble being functional, one weighs the pros and the cons. My DS takes low-dose Zoloft, and I know some other kids here also find that low-dose Zoloft, Prozac, etc. can "take the edge off" their anxiety. If you decide to go that route, though, make sure the dosage is very low to begin with, since too high a dose (even if it's within the range of "normal" for a kid of a certain age, per a typical doctor or psych) can be too much and activate our kids. Good luck! Hang in there!

I'm not sure, either, how you could definitively separate yeast-related behaviors from PANDAS behaviors, but, just logically, I'd tend to see it your way: if those rages and OCD behaviors evaporate when she's on abx, then it seems unlikely that they are 100% attributable to yeast. If anything, if the yeast were a primary (as opposed to secondary) concern, you'd think the negative behaviors would increase when on abx because the yeast has more of an opportunity to profligate then, right? FWIW, too, we saw the same pattern with our DS, especially early on in abx treatment. OCD and anxiety (his only rages at the time were fairly internal, as opposed to external) would decrease substantially when on abx; we'd quit or cut back, and by Day 8 or 9, we'd see the behaviors start to creep back up in frequency and intensity. If we didn't return to abx, by Day 12 or 14, he'd practically be back where he started! And all of this continued to re-occur each and every time we tried to reduce or remove the abx, even when we couldn't find any sign that he'd been exposed to or was suffering from any bacterial or viral component. He's generally hyper-immune anyway, though, so he frequently doesn't "actively catch" things but will rather "carry" them and give them to the rest of the family, or react to them behaviorally rather than physically. In our case, keeping him on abx has been key, but we've also had to supplement with other interventions: therapy, low-dose SSRI, supplements, low-dose mood stabilizer, etc. to really keep him on an improvement trajectory. He takes a fair amount of probiotics, also. I've taken Diflucan in the past, and the down side to that is it can be hard on the liver. I know other families here have used it, though, so it might be worth a short trial. But will the doc test for candida or some other "negative yeast" before actually prescribing? At any rate, if you don't see improvement in the behaviors reasonably soon after starting it, you'll probably have your answer.

My DS is now 14 and was 12 and 130 pounds when he first began the XR so LLM may be right; your DS may be too young and too small for the XR as it doesn't come in anything smaller than 1,000 mg. tablet. It is something to be aware of, meanwhile, that the actual ADULT treatment dose of XR is 2,000 mg. twice daily, as compared to the 1,000 mg. twice daily as prescribed for Sammy Maloney and a subsequent number of our PANDAS kids. So despite the high-appearing number/dosage, it is still effectively one-half the dosage an adult is prescribed for sinus infections and the like. I guess it would take a very knowledgable doctor, however, to truly discern an appropriate dosage for PANDAS purposes. Meanwhile, if azith worked so well for you in the past, and there are many, many folks who's kids are taking azith regularly as a prophylactic without adverse side effects like liver damage, perhaps all your doctor needs is a little more information to that end? I don't know of any peer-reviewed papers specific to that topic, but perhaps someone else does. Or perhaps your doctor could be put in touch with one of the docs who regularly prescribe azith for PANDAS and be given some professional-to-professional consult on the topic? Finally, as for possible liver damage, 1) it could be monitored, 2) as discussed repeatedly here, kids here on the forum who've been taking abx for extended periods still seem to be okay in this regard (though I know that's largely anecdotal and probably not capable of swaying a conservative physician), and 3) supplements such as NAC and milk thistle are liver-supporting and have been researched for reversing damage done to the liver by things like acetominephin overdose, etc. So you could add those to your son's regimen perhaps?

Just curious . . . why won't his doc prescribe Azith? This does seem to be a successful abx for many, both as treatment and prophylactic. Our DS responded well to regular Augmentin originally, also, but then he plateaued, even though he didn't actually backslide while still taking the Augmentin. After the first 30 days of that, though, we were able to convince our ped to prescribe Augmentin XR, and he's been taking that ever since . . . almost 2 years straight now. We have occasionally tried to "downshift" again to regular Augmentin, but he never does as well on it as he does the XR. The only explanation I can come up with is that the XR is extended release, and that keeps the drug active in his system longer and more consistently.

I hardly ever read fiction anymore. Even when I'm not reading about kids or immune disorders or processing disorders or OCD, I find myself picking up nonfiction books like "Leaving Microsoft to Change the World" or "Reality is Broken." Just this week, though, I decided to read one of the two books on my DS14's summer reading list for entering high school while he reads the other one. He's reading "Rules of the Road" by Joan Bauer, and I'm reading "Twisted" by Laurie Halse Anderson. It's fiction, but anything but frothy or light, summer reading. I'm a little concerned, frankly, about DS reading it, as I'm certain it'll set off some scrupulosity issues over the very bare, teenage issues it addresses (alcohol, sex, bullying, selfhood, parental vulnerability).

Sorry, Smarty. I remember that microscope drawing, too, but now I'm having trouble finding it myself. Was it in Swedo's presentation materials, maybe? So it might be on last year's AO conference DVD? Or maybe it's in this older presentation, as well, that was posted a while back? I've tried looking at the video again myself, but it's a lengthy one and, unfortunately, my available bandwidth here at my office during the day is challenged by the hosts of other users on-line currently. Maybe you could skim through it to see? ACN Link - Swedo Video The other suggestion might be to check Dr. K.'s website. He used to have a couple of "before" and "after" drawings posted there, as well. If they're no longer available, let me know, and I can get you a PDF copy of the page that I created several months back; my copy has a drawing of a girl in it, before and after treatment, that might help for illustrative purposes in terms of small motor/writing/drawing abilities during exacerbation versus out of exacerbation.

LLM -- Firstly, given as this boy's story sounds so similar to my DS's, I hope your friend is open to looking into what might be behind the anxiety besides heredity, "organic wiring," etc. Success with one SSRI for many years with respect to controling anxiety, only to have its efficacy begin to fail eventually, and switching to yet another SSRI, with nominal, if any, positive impacts . . . . . that sounds almost exactly like our experience pre-antibiotics. So . . . . I also know from experience that, depending on the prescribing physician, some of our kids are better off with HALF (or less) of the "standard recommended" SSRI dose, and that increased anxiety and depression can actually be a sign that the dosage currently being taken is too high. It's not technically serotonin syndrome or even akathisia, but is IS "activation," and to us, it just looked as though DS's anxiety, OCD and sadness was intensifying. As for GABA, SAMe or 5HTP, I can't speak to that as we've not tried those. I don't see anything in the literature that suggests that you can't take GABA along with SSRIs. None of the things I've read regarding GABA even mentions serotonin or even dopamine. However, I understand that 5HTP is counter-indicated in conjunction with SSRIs because the combination can lead to serotonin syndrome; I've read the same with regard to SAMe. I don't know that NAC will be of immediate-enough efficacy to help in the current circumstances, though I do think it would help in the long run. During the darkest hours, we found a good bit of help with Valerian root . . . morning, noon and night! Ibuprofen helped, also. So sorry for your friend, and hope something helps soon!

Thanks! It makes some nice points I've not seen so succinctly brought to light by other stories/articles.