Medications for TS

[Kayanne]

I always post on the PANDAS forum because my six yr old daughter has it, but I now have question regarding the treatment of the OCD component of TS.

 

My husband has a diaganosis of anxiety/panic disorder without agoraphobia and hypervigilism. He has used paxil in the past, but switched to Zoloft because it has less side effects. However, he did still have weight gain, drowsiness, mild lack of motivation as side effects.

 

After a few years of CBT, and lifestyle changes (exercise and meditation), he succesfully weaned himself off the medication. That happened this past spring, when all #@** broke loose in my house with my daughter's PANDAS. He did mange to do okay with all of that stress.

 

He lost his job, and started a new one...really rampiing up his anxiety and panicked feelings. He has been thinking of going back on the medication, and I am leaning toward that since he doesn't want to see a naturapathic dr, the test for other health issues first.

 

When we met with a pediatric psych in April, she said my husband has a facial tic, and then we met with a pediatric Rhumatologist (whose son has TS) and he also seemed to think my husband has a facial tic. I know what they are talking about, I just always assumed it was his nose bothering him or something like that...it was actucally more pronounced when we met at 16 yrs old, than it is now at 37.

 

He claims that he can stop it anytime, it is just his nose bothering him, but I've read that in some cases of TS the patients can still have a good bit of control over the tics...

 

I guess I should also add that he has very sensitive hearing and smell...I think I have read somewhere on this forum that these things could also be a symptom of TS.

 

So anyway. all of this has lead up to my question. What if he really has a mild case of TS? Would the medications for the anxiety/panic/OCD of TS also be SSRI's?

 

Thanks a lot!

 

~Karen

[Chemar]

Hi Karen

 

many conventional docs do prescribe the SSRI antidepressants for the OCD that is often comorbid with TS

 

altho the OCD with TS is frequently somewhat different from "classic" OCD or even from the OCD that I hear some of the PANDAS parents describe, still the basis for it appears to be a deficiency in serotonin.

 

the OCD with TS is sometimes "tourettic OCD" where tics can become OCD and vice versa...very distinctive. Still, even with this, other more "classic" OCD symptoms can also exist

My son's OCD falls into this mixed definition

 

my son was on Luvox initially but it really zombied him, much personality damping as well as resulting in a total loss of interest for the artistic/musical talents that were his passion! it also sadly caused some psychotic reactions (tho in fairness it is believed that may have been a result of the combination of luvox and haldol that the neuro/psych had him on initially) However I can say emphatically that the Luvox never really helped his OCD much, IMHO in a way maybe even triggered new aspects of it

 

we had to go thru a very very slow weaning and rather debilitating withdrawal period when he came off the meds but it really was a relief to see his personality return...I will never forget the joy I felt the day I saw the familiar mischievous sparkle in his eye replacing the dull glaze he had on the meds

 

amyway....I mentioned the med reaction just to say that we actually found a combination of CBT and natural serotonin boosting supplements to be far better at controlling his OCD than the Luvox ever was

 

but if your husband responds well to SSRIs then yes, those are what are also rx for TS OCD because at the primary purpose is to increase serotonin

[Kayanne]

altho the OCD with TS is frequently somewhat different from "classic" OCD or even from the OCD that I hear some of the PANDAS parents describe, still the basis for it appears to be a deficiency in serotonin.

 

the OCD with TS is sometimes "tourettic OCD" where tics can become OCD and vice versa...very distinctive. Still, even with this, other more "classic" OCD symptoms can also exist

My son's OCD falls into this mixed definition

 

Do you have any recommendations on where I can find more information about these OCD distinctions?

 

amyway....I mentioned the med reaction just to say that we actually found a combination of CBT and natural serotonin boosting supplements to be far better at controlling his OCD than the Luvox ever was

 

Do you use these serotonin boosting supplements under the supervision of a doctor? Do you think it is safe to try something like this without a dr overseeing?

 

I read a little about HTP5, and it seems to have the same side effects as prescription SSRI's, which makes me think, Why bother, the zoloft is covered by our prescripion plan?

 

Given my husband's reluctance to try a more natural/holistic approach--I'm afraid to just start using supplements blindly. At least wtih the SSRI he has a psychiatrist and therapist helping him.

 

Thanks for responding.

 

~Karen

[Chemar]

Hi Karen

 

yes we did have doctor guidance for the supplements

 

when my son was in severe OCD waxing after the med withdrawal, the psychiatrist who was supervising the withdrawal recommended 5HTP and it did have a really positive effect on my son, with a rapid decline in some very alarming OCD symptoms he was having at that time. he was using a minimal dose tho (50mg each evening)

 

once his OCD was stable (still there but not the awful intrusiveness like before) he slowly came off the 5HTP and remained on Inositol (one of the B vitamins), methionine and St John's wort which helped

 

we removed the SJW as well as long term use isnt recommended and the hypericin in it can also cause sensitivity to sunlight

 

when he tried 5HTP again a few years later during an OCD flare , he did not respond well..it made him edgy and restless)

 

he went on a high dose of Inositol then(12-16 gm a day) and it brought the OCD back under control. Again, high dose Inositol is not recommended longterm

 

recently he decided to try the samE form of methionine and that has had a very very positive effect. He still takes around 1 gm of Inositol daily

 

I should also mention that he finds taking Vit B6 (he uses the P-5-P form) and vit B12 (MUST be the methylcobalamin not the poorly absorbed cyanocobalamin) along with vit D3 are essential to his general mood and helping the OCD/anxiety issues. He notices a big difference if he isnt taking these

 

 

re the distinctions in OCD, there are a number of threads here related to it. We first came to understand

the difference when under the care of a psychiatrist who showed me a number of research papers related to "tourettic" OCD with the morphing of tics into OCD symptoms and vv that we saw in my son