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Prevacid and/or Pepcid?


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My DS14 began to show signs of increasing anxiety about a week ago, and this weekend it pretty much hit the fan, at least insofar as homework was concerned. At first I thought he was just "conning" DH because I was gone all day on Saturday (ironically, at the Pandas Parents meeting), and DH is a little easier to manipulate when it comes to procrastination, diversion, etc.

 

But on Sunday, DS was really out of sorts, developed hives, his eczema on his elbows and wrists went into overdrive, etc. He was belching constantly, and when we gave him a valerian root in the interest of calming him down a little, he actually had a reflux incident and came flying downstairs to grab a glass of water to chase back the nasty-tasting valerian that came back up his esophagus! Ick! Then he disclosed that this reflux stuff happens "a lot," which was the first we've heard of it since he was an infant!

 

DH takes prilosec, and since I remembered something from earlier on here about reflux/GERD and some of these remedies that also have other characteristics that can be helpful to PANDAS kids, we gave DS a prilosec. Then, when I went back in the forum to do a search, accompanied by some quick web research, I found that some acid reflux rememdies like Tagamet, Prevacid and Pepcid have antihistamine characteristics along with their proton pump inhibitor qualities; prilosec, unfortunately, does not. I guess the others, though, work on the H1 receptors in the gut and thereby curb histamine production?

 

So I wanted to revisit this. If DS genuinely is experiencing frequent reflux, especially when having increased anxiety, and it seems obvious his histamine production is high (hives, eczema), maybe this is an intervention we should consider?

 

Your thoughts? Thanks!

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Hi Momwith - I did a quick hunt when we were looking at methylation in general and came up with quite a few studies that seem to point at H1 inhinbitors, the usual antihitamine-hive-type suspects, as decreasing BBB efficacy, whereas H2 inhibitors like ranitidine and cimetidine (zantac and tagamet) increasing efficacy of the BBB. I just did a search for 'histamine BBB' and got more than I could read/digest. If I were going to use a GERD type medicine, I think I would be sticking to H2s which most are, I believe.

 

I had also read in the past, but couldn't find the reference when I went looking for it, that not only do H1 antihistamines cause the temporary type cognitive issues in the elderly that are often cited and recognised but can also leave continuing issues in those especially with an already existenting dementia. Which would make sense if they decrease BBB efficacy.

Anyways - not quite what u were after but thought I'd mention it...

 

I won't be using H1 antihistamines on my kids until I can research and discuss further with our Dr (sudden food allergic response aside as we had this week when dd who has severe cashew allergy came home having been given a cashew cookie at school by a parent helper, who when she realised her mistake told dd 'Im' sure you'll be ok" and didn't bother to tell the teacher :angry: ) and I am considering trying H2s as a treatment.. if we all get ANAs, does it matter how many? One wolf at the door or many, who cares as long as your door is solid? Don't know if it'll work but it seems fairly innocuous as a treatment trial. I'll let you know what our Dr says and how it goes when/if we try it.

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We use prevacid. I did the same thing in terms of viewing a medical issue as anxiety! :wacko: I think I told her for about 6 months, that I knew she "felt like her stomach hurt, etc, but she was fine". She also often described feeling like she was going to barf, or complaining about a metal taste. After doing ERP therapy, and eliminating the panic, we realized that her pain/metal/barf complaints actually had a clear pattern related to food/bowel timing. So we consulted a GI, did an endoscope, and found that she had ulcers - normally caused by bacteria - but no evidence of H Pylori. We now use prevacid. My only complaint is that we can't get her off it. I probably used it too long, but we were really afraid to change anything. She rarely has stomach complaints now, although she was also diagnosed with the "symptom" disease of IBS.

 

I should add, that stomach issues did not exist before PANDAS, 2nd episode.

Edited by Meg's Mom
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Thanks, dut and Meg's Mom. I'll have to look into that H1 versus H2 stuff. I'm just thinking that since excess histamine seems to be problematic in more ways than one, adding one of these gut remedies might not be a bad idea. Until he mentioned it, I had no idea that DS was dealing with frequent reflux; I guess he thought that was "common," so there was no point in mentioning it.

 

Meg's Mom, just out of curiosity, in addition to the ulcers, did/does Meg have any allergies, seasonal or otherwise? And, if she does, did you notice an impact on any of that made by the Prevacid?

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Be aware, proton pump inhibitors can cause B12 deficiency.

 

Thanks, I'll keep an eye on that. DS takes B-complex supplements, and there seems to be something of a delicate balance between B12 and histamine anyway, since B12 can also drive histamine production. In our case, it seems as though we're dealing with plentiful histamine production, so I'd like to see if we can get that under better control.

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Those things worked only a little bit for me. What worked much better was treating the fungal infection with antifungals. I think it's much more likely that the millions of people on these things have fungal infections than it is that they have malfunctioning proton pumps.

I don't know if there is a connection between fungal/yeast infections and histamine, but these anti-acid drugs work by blocking histamine receptors (H2, in the digestive tract) that are responsible for triggering acid production. So, not necessarily proton pump malfunction-

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Those things worked only a little bit for me. What worked much better was treating the fungal infection with antifungals. I think it's much more likely that the millions of people on these things have fungal infections than it is that they have malfunctioning proton pumps.

I don't know if there is a connection between fungal/yeast infections and histamine, but these anti-acid drugs work by blocking histamine receptors (H2, in the digestive tract) that are responsible for triggering acid production. So, not necessarily proton pump malfunction-

 

And wouldn't it tend to follow that fungus does not thrive in an acidic environment? I would think that people with low acid production would be more inclined to fungal infections in the gut than would those with excess acid? :blink:

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Be sure to keep up the probiotics while on PPIs, because taking them could increase the risk of c-diff. Stomach acid keeps c-diff down. PPIs keep stomach acid below the level of protection against c-diff.

 

My experience with this: dd started with GERD in Nov 2010. Doctor put her on prevacid in December. I had a conversation with the owner of Custom Probiotics who suggested that my daughter should probably not take prevacid due to her history of c-diff in 2006. He said you need some acid to balance out the good/bad bugs. I went back and asked the doctor, who said there is no relation to the prevacid. In April 2010, she got c-diff while still on it. FWIW.

Edited by philamom
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Nancy,

Any coincidence with starting SAMe?

 

Laura

 

I don't think the two things are related; after trying SAMe for 7 days, we saw DS ramp up a little bit, so we stopped it, thinking he was potentially getting activated. He's been off the SAMe for over 10 days now, and when we've seen activation in the past due to too high an SSRI dose, he calms down within 48 hours of reducing the dose again. But what we thought was attributable to the SAMe may even have been actually due to a bug.

 

His hives which were present on Sunday and went away on Monday are back this evening, and when he got home from therapy this evening, DS told me that I should keep my distance from him because he's "coming down with something." I couldn't help but chuckle and tell him that I could've told him THAT!

 

In the end, we have decided against the SAMe, at least for now, but he's clearly coming down with a cold virus or something along those lines.

 

The reflux, meanwhile, I'm still trying to discern if it's the chicken or the egg. Did he have reflux yesterday, especially, because he was frustrated and stressed, or was a histamine response in his body in part driving both the stress and the reflux?

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Thanks, dut and Meg's Mom. I'll have to look into that H1 versus H2 stuff. I'm just thinking that since excess histamine seems to be problematic in more ways than one, adding one of these gut remedies might not be a bad idea. Until he mentioned it, I had no idea that DS was dealing with frequent reflux; I guess he thought that was "common," so there was no point in mentioning it.

 

Meg's Mom, just out of curiosity, in addition to the ulcers, did/does Meg have any allergies, seasonal or otherwise? And, if she does, did you notice an impact on any of that made by the Prevacid?

 

Had her tested for everything under the sun :). well, almost. There is more to test for now than there used to be!!! No known allergies. No major changes in her life except for major relief of stomach pain and nausea. Her's was clearly ulcers, since we could see on the endoscope. No clue what "caused" them however. But that is the story of her life!!

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My DS14 began to show signs of increasing anxiety about a week ago, and this weekend it pretty much hit the fan, at least insofar as homework was concerned. At first I thought he was just "conning" DH because I was gone all day on Saturday (ironically, at the Pandas Parents meeting), and DH is a little easier to manipulate when it comes to procrastination, diversion, etc.

 

But on Sunday, DS was really out of sorts, developed hives, his eczema on his elbows and wrists went into overdrive, etc. He was belching constantly, and when we gave him a valerian root in the interest of calming him down a little, he actually had a reflux incident and came flying downstairs to grab a glass of water to chase back the nasty-tasting valerian that came back up his esophagus! Ick! Then he disclosed that this reflux stuff happens "a lot," which was the first we've heard of it since he was an infant!

 

DH takes prilosec, and since I remembered something from earlier on here about reflux/GERD and some of these remedies that also have other characteristics that can be helpful to PANDAS kids, we gave DS a prilosec. Then, when I went back in the forum to do a search, accompanied by some quick web research, I found that some acid reflux rememdies like Tagamet, Prevacid and Pepcid have antihistamine characteristics along with their proton pump inhibitor qualities; prilosec, unfortunately, does not. I guess the others, though, work on the H1 receptors in the gut and thereby curb histamine production?

 

So I wanted to revisit this. If DS genuinely is experiencing frequent reflux, especially when having increased anxiety, and it seems obvious his histamine production is high (hives, eczema), maybe this is an intervention we should consider?

 

Your thoughts? Thanks!

 

 

We use Pepcid by mouth and IV as a normal part of the "cocktail" for allergic reactions in the ER for the Histmaine blocking effects (H2 blocker). Available OTC. Can take up to 40 mg daily for adult sized dosing. Prevacid is largely Proton Pump Inhibitor (PPI) as is Protonix and Prilosec. These are NOT beneficial for histamine blocking effects for allergic reactions but are great for reflux/GERD type symptoms. Zantac and Tagamet are H2 receptor antagonists...little different mechanism of action...close but not exactly the same. Tagamet can have some anxiety type side effects in some folks. Climbing the wall, coming out of you skin type feelings- especially longer you take it and in older population. Zantac is better tolerated out of the those two. Again, good meds for heartburn and reflux. Older meds. Available OTC.

 

However, for histamine blocking effects- my money goes for Pepcid. My mother has severe allergies- eyes swell, large skin hives, tearing etc. She takes Benadryl like candy, has allergy eye drops etc. I told her to add Pepcid when she has flares and she could not believe the difference. It is the best H2 blocker, IMO, and supported with how the docs use it for allergic reactions in the ER.

 

Zyrtec is a H1 receptor antagonist as is Claritin and Allegra. Peripherally selective- 2nd generation.

 

Benadryl is 1st generation- nonselective

 

You can block the H1 and H2 with a cocktail of Pecid and one of the allergy meds listed without the more sedating effects of Benadryl. And, without as much of the drying out senstaion (anticholingeric)

 

Course, there are some older antihistamines that are still good also- particularly for itching- Vistaril/Atarax, Tavist, Clor Trimeton etc.

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