SSRI, Tenex--possible interaction with Zithromax

[tassal]

Hi Everyone:

 

I just joined this forum. My son is seeing Dr. T. We are also patients of Dr. G (nids) in California. We are following NIDS protocol but have recently started to think something PANDAS is going on too. My son never tested positive for any kind of strep. We saw Dr. T and he ran the whole gamut of PANDAS tests--12 vials of blood! All results were negative except for HHV6 which was still strongly positive (it's been positive every time we've checked, going as high as 600 about 6 months ago--we are combatting that currently with Famvir). So no lyme, no mycoplasma etc.....

 

Dr. T suggested that my son does not make antibodies to strep. The reason being that he did not show any antibodies to strep despite being exposed to strep many times (everyone in family has had it but him). So he put my son, who is 8, on a small dose of Zithromax for 10 days. Other medications that my son takes are Celexa (25 mg daily), Tenex ( 1/2 mg daily) and Nizoral.

 

The 10 day course of zithro did seem to reduce his constant stimming. Additionally, I would say that he's been much more interested and capable of "play". He's suddenly discovered play doh, cannot get enough of it! He's ready to play games and other things that he has never shown any interest in whatsoever. These have been good things....in forum members' opinions, could this be related to the zithromax?

 

But now for the negative stuff going on...every day around 10AM my son is having massive, intense temper tantrums at school where he is injuring himself and occasionally his teachers. He gets so incredibly mad that they have to isolate him in a separate room. Up until about 10AM he is fine, works amazingly well and is focused. He simply loses it, unprovoked. The tantrums were so bad last week that he was falling asleep afterwards because of the exertion. He was throwing about 2 at school and then one to two tantrums after school. Usually during transitions. His gymnastics teacher quit because he hit her in the nose by accident and gave her a nose bleed. Things are bad.

 

Has anyone experienced any interactions between Tenex or Celexa and Zithromax? My son gets Celexa and tenex around 8:30AM and Tenex again at 2PM. I'm starting to think that perhaps something happened during the time that he was on zithromax that intensified the Tenex or the Celexa? He's been off of the Zithro for exactly a week now--is it possible that an interaction would last beyond the time he was taking Zithromax?

 

I'm simply at a loss.....I guess another question would be, Do Pandas kids do badly on Tenex? We had an extremely negative experience with Intuniv, which is 1mg time release Tenex. My son had an immediate and extremely negative reaction to it. We ended up trying it twice per Dr. G's instructions and both times the reaction was so bad, we immediately pulled it. Perhaps that should have been a clue to not use Tenex either (although at a much milder dose)?

 

I'm trying to explore all avenues as to what is going on with my son because things are so bad right now. I've reached out to Dr. T but he's not available as I'm sure most of you know. Any insight into what could possibly going on with my son would be GREATLY appreciated!!!! Thank you!!!

Edited March 4, 2013 by tassal

[LNN]

Hi and welcome to the forum.

Is the tenex new for your son? How long has he been on Celexa and at this dose?

 

Zithromax generally has a half-life of about 36 hrs. but it builds in your system. So a 5 day course is in your system for about 10 days. So if there were a bacterial infection, yes, the zith could still be killing it and if that bacteria is a type that releases toxins when it's killed, you could be seeing what's called a herxheimer reaction - the body responding to the toxins. Some strains of strep release toxins (this is what causes scarlet fever rashes with some strains of strep). Lyme bacteria, yeast and mold funguses also release toxins. Has your son been tested for lyme? I don't see any treatment for the HHV-6 - is that being addressed?

 

Perhaps if you could give a bit more history, it would help. Also, as a general rule, we try not to post the full names of doctors. This is a public forum and it's best to keep our own names as well as doctors names confidential. Usually you'll see a doctor called by his/her initial of the last name, so Dr L, Dr K etc. And then if you need to know more, you can send a private message to someone by clicking on their user name, which will bring you to the user's page and you'll see an option to "send me a message". You can recieve private messages by clicking next to your user name in the upper right corner at the top of the forum page and you'll see "messages" where you can go read your private mail.

 

If you'd like to edit your original post you can click on your post and you'll see "edit post" as an option on the bottom of the text box. (only you can edit your own posts).

[smartyjones]

But now for the negative stuff going on...every day around 10AM my son is having massive, intense temper tantrums at school where he is injuring himself and occasionally his teachers. He gets so incredibly mad that they have to isolate him in a separate room. Up until about 10AM he is fine, works amazingly well and is focused. He simply loses it, unprovoked. The tantrums were so bad last week that he was falling asleep afterwards because of the exertion. He was throwing about 2 at school and then one to two tantrums after school. Usually during transitions. His gymnastics teacher quit because he hit her in the nose by accident and gave her a nose bleed. Things are bad.

 

i'm sorry -- i'm not really able to respond to your original, actual question -- i know nothing about ssris. my ds was originally put on a 5 day course of azith for pandas and had a horrible reaction initially. he improved when he got off it.

 

i did want to mention something else -- you say 'unprovoked' -- i'd ask exactly what is happening at the time he goes off in this tantrum. it could be that there is something that is a trigger to him that appears completely benign to the teachers. -- is he changing classes, activities, particular people -- ? OCD can be very tricky and very difficult to decipher, especially if you are just beginning to look at it as OCD.

 

there was one time my ds would not come inside and end the family baseball game -- there had been plenty of timelines, warnings, etc. that the end was nearing. on the surface, it appeared as if he was just being defiant and wanted his own way. that particular instance, he was able to express that what seemed to everyone else a reasonable time to end ( thru the batting order or something) was not to him. he was on 2nd base. he NEEDED to come home or he would be left on 2nd base all night and that was absolutely intolerable to him. he has 'just right' OCD and that was not right at all. had we not understood this, it easily could have been an extreme tantrum.

 

so -- i'd wonder if there is anything like that happening at the times he loses it in this extreme tantrums.

 

good luck!

[rowingmom]

If you take a look around the forum you will find that a lot of the children here are quite sensitive to psychiatric drugs, and that normal doses do tend to cause over-reaction. Welcome. There's so much to learn from the parents here.

 

Also, I PM'ed you.