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Bad headaches at Night, suggestions?

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My ds was diagnosed with pandas 3 months ago. We are on Zoloft 50mg and 250 mg azithrmycin, culterelle probiotic.  Each evening and especially around bed he gets awful headaches which is also when he can be irritable etc and has very hard time settling down to go to sleep. He will take 2ibuprifen which helps some but not much and refuses to take melatonin. Any suggestions to help lessen headaches and inflammation at night since he’s stubborn and won’t take other things we suggest?  Also does anyone know if melatonin is tasteless if I break a capsule and mix in a drink?

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Did the headaches exist before going on Zoloft?  Although the 50mg is not a high dose by traditional standards, it may be sky-high for some PANS/PANDAS kids.  Have a look at this study:


This talks about symptom activation (which includes irritability), not specifically headaches or not being able to settle down to sleep, so it is not perfectly correlated with your question.  But it might be part of the puzzle.  Not all PANDAS kids have this kind of activation on even very low doses of SSRI's, it was 14 out of 38 that were very sensitive, so this may or may not apply to your child.

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I have melatonin drops. They have a pretty awful flavor, but I’m not sure it’s the melatonin or something added. We have a terrible time with sleep- both going to bed and staying asleep. Magnesium about half an hour before bed seems to help a little. So does a bath with Epsom salts. Aleve at night seems to help my guy. The most helpful thing we tried was GABA which worked like magic for about two months and just stopped. Now we are trying CBD oil. We will see if that helps. Best of luck. Hope this helps!

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