Worse with a cold--variability in symptoms?

[Rachelle]

My son responded to NAC well (improved OCD by a huge amount, stopped repeating his words, much better emotional control). We were and are doing 600 mg twice a day. He's 8 and 40 pounds.

 

Then he got a pretty nasty cold and went back to the severe OCD/repeating words/extreme emotional mess. He was as bad or worse than before we started the NAC.

 

Do you see such variability with viruses? I'm trying to figure out if it might be that the cold was interfering with sleep and the OCD is worse at night so he wakes and then the OCD takes over. Maybe also the lack of sleep would make daytime symptoms so much worse too along with the emotional stuff. I can't figure out the repeating words variability. He's on the autism spectrum but he hadn't been doing that before the OCD started...go to the park, park, park sort of thing--it doesn't seem to be OCD but more of a stim. We didn't have any big indicators of PANDAS/PITANDS so I'm wondering if OCD just normally varies like that.

 

Or does OCD just sort of swing in terms of symptom severity from week to week anyway?

 

It was very discouraging to think the NAC was helping and then see him get so bad again. I don't know what to think.

Edited August 31, 2012 by Rachelle

[MomWithOCDSon]

My son responded to NAC well (improved OCD by a huge amount, stopped repeating his words, much better emotional control). We were and are doing 600 mg twice a day. He's 8 and 40 pounds.

 

Then he got a pretty nasty cold and went back to the severe OCD/repeating words/extreme emotional mess. He was as bad or worse than before we started the NAC.

 

Do you see such variability with viruses? I'm trying to figure out if it might be that the cold was interfering with sleep and the OCD is worse at night so he wakes and then the OCD takes over. Maybe also the lack of sleep would make daytime symptoms so much worse too along with the emotional stuff. I can't figure out the repeating words variability. He's on the autism spectrum but he hadn't been doing that before the OCD started...go to the park, park, park sort of thing--it doesn't seem to be OCD but more of a stim. We didn't have any big indicators of PANDAS/PITANDS so I'm wondering if OCD just normally varies like that.

 

Or does OCD just sort of swing in terms of symptom severity from week to week anyway?

 

It was very discouraging to think the NAC was helping and then see him get so bad again. I don't know what to think.

 

Rachelle --

 

We have a PANDAS-savvy psych, and she has said that even regular OCD can increase with illness . . . immunological inflammatory response, increase in some neurotransmitters (like histamine), etc. . . . and can therefore exacerbate behavior.

 

As for the NAC . . . our experience would suggest that if it helped before, it can help again. Among its properties, though, is biofilm busting and mucous thinning, which could be sort of ramping up the symptoms of the cold/virus before it can get back to some of the other properties (glutamate modulatory) that more directly helps OCD.

 

Have you considered adding an H2 (histamine receptor 2) blocker, like Pepcid? It can help control histamine levels without drying out the sinuses, etc. and may help your DS's ramped up behavior during the cold/virus.

 

Good luck!

[rowingmom]

My DD11's word repetition (repeating herself - palalalia, repeating others - echolalia) is apparently a form of verbal ticcing (she says she gets premonitory sensations). This began about the same time as her motor ticcing after a rash reaction to a bug bite in 2008. I paid it little notice (thinking it was just a quirky kid thing), and because it doesn't happen all the time her pediatric psychologist didn't see it either. I was told that she would have a dx of Tourette's if vocal ticcing went along with her motor tics for more than a year (which they did).

 

Both her motor and vocal ticcing, as well as other PANS symptoms - decrease in handwriting ability, slight OCD, urinary frequency, emotional lability - and social regression (loss of maturity level) and aspergerish symptoms wax and wane with bacterial/viral infection as well as with changes in abx combinations. Several times during the last year and a half she appeared to be NT (no ticcing, OCD, PANS symptoms), but if she is coming down with a viral infection (or strep infection) her symptoms will reimmerge. They were expecially bad while we were pulsing tindamax this summer to try to kill the cyst form of lyme. Two weeks after discontinuing tindamax, ticcing is gone, most other symptoms have resolved.

 

We are now in the midst of switching abx so who knows what will happen.

 

DD11 and I do notice that if she has a fever during viral/bacterial infections most of her symptoms resolve while she is febrile, but tend to be worse on either side of the infection.