When to start CBT?

[FLmom]

My ds13 has been on Augmentin since Thanksgiving. No dramatic improvements. This past week has been fairly well (but OCD still high) but that could be due to being out of school, so no rages over homework etc. He is scheduled to go back to USF Jan 8, and I was hoping to switch to Zithromax. The problem is Dr. Murphy also wanted him to start CBT at USF. They called me a few weeks ago and highly suggested us participating in a research study for OCD and d-clyclomine (I believe-can't remember the exact name) to extinguish behaviors. This isn't a pandas study, but strictly OCD study.

 

Our appointment to get set up for that is Jan 7, the day before we see the doctor again. Dr. Storch, the psychologist, said I wouldn't be able to switch antibiotics for my son since they have to keep everything the same during the study (10 weeks). So I'm really struggling what to do. I hate to have my son on an antibiotic that might not be doing anything for him for another 3 months when he could be trying something different. If we postpone the therapy, and start Zithromax, we'd have to wait several more weeks before starting the study to let his body adjust to the new antibiotic.

 

Of course they are closed for the holidays and won't re-open until the 6th, so I hate to call that day and cancel with such short notice. I'm really leaning toward postponing it, and seeing what results we get with a different antibiotic, but the OCD is so bad that I'm getting desperate for him to start something. However, he did get some CBT from a local therapist over the summer with no success. So if he isn't getting the right medical treatment, he might not have any success with the therapy anyway.

 

I think I know what I need to do, but wanted to be sure there was no reason that I should go ahead and press forward with the CBT, and just keep him on the Augmentin.

 

[PowPow]

One month , in my opinion, is not quite long enough to determine whether or not augmentin is working.

If you think he will cooperate wiith cbt at usf, I would do their study in a heartbeat. Cbt there is excellent and a chance to try the d-cycloserine!. It has shown very promising results.

[FLmom]

How long would you think before one knows if they have hit upon the right antibiotic. (or we could be dealing with lyme etc. also)? And if his OCD improves with the CBT, how do we know if it is the therapy or antibiotic? He has no tics -something that is more objective. And while I want to OCD to go away, I look at it as a symptom of what is going on inside. We have lots of learning issues, math, memory issues, raging that isn't at concrete to judge if healing is taking place.

 

I am also waiting on c4a results that should be in by now, but office is closed until after the 1st. Last year it was high, and if it is higher now, well, then I may be back to square one.

 

Should the OCD improve with CBT even without the medical treatment in place?

[Mommy2MCL]

Have you tested for all co infections? My daughters blood work came back clear for strep (even though she had had it 3 weeks prior) but high IgG and IgM for Myco P. Once we switched to Zithro she has really improved.

 

Also, if you have tested for co-infections and know strep is the culprit. I think right now the main concern would be finding the right antibiotic to start your sons healing process. Or at least find out what his risk are at contracting another infection if the antibiotic is not the right one.

[MomWithOCDSon]

Personally, I don't think you run the risks of "muddying" a picture by commencing with CBT, and if the focus remains your child's overall health and functionality, then CBT is likely an important component of that when OCD behaviors are part of the picture.

 

If his underlying medical condition is not being adequately addressed by the current antibiotic, the CBT is not going to "wipe away" all signs of that remaining autoimmune imbalance. But what it will do is help support your DS's day-to-day functioning and help give him tools to prevent the OCD from becoming a bigger and more difficult component of the illness while he proceeds with medical healing and/or you continue to seek out alternative medical interventions. In delaying the CBT, meanwhile, you run the risk of your DS permitting the OCD to become something more than a mere symptom of an autoimmune dysfunction . . . it can become more habitual and thus more difficult to set aside or quell more permanently.

 

Dr. Storch is the finest there is in this field. I think your trust will be well-treated in his hands.

[airial95]

We' ve done CBT with Dr. Stortch's team regularly for the past several years for both of my kids. It has been a god send. They "get" PANDAS. Even though the study (and therapy techniques) are the same for standard OCD and for PANDAS - they understand the subtleties associated with the PANDAS kids. We love them over there.