Another Potential Reason Why Abx Work Long-Term?

[MomWithOCDSon]

I know this research article has floated around on the forum for several months now, but my DH has only recently decided he wants to catch up on his PANDAS reading so that, when I make a pronouncement that we're adding this supplement or whatever, he's not just playing Follow the Leader.

 

Glutamatergic Dysfunction in OCD

 

Anyway, he was reading through this particular article and came across something I'd somehow missed (or potentially dismissed) in previous reads. It reads as follows on the last page of the article:

 

Another exciting new treatment possibility is raised by a recent study revealing the unexpected finding that B-lactam antibiotics increase the expression of glutamate transporters on glia and have neuroprotective effects in a mouse model of ALS. Because of the extensive tolerability data on such compounds, they represent and exciting and unexpected group of potential antiglutamatergic agents for use in OCD and other neuropsychiatric disorders.

 

Augmentin is a b-lactam antibiotic, so maybe this explains why long-term Augmentin XR has been so helpful to those kids (like Sammy) with significant PANDAS OCD; it's not just addressing the strep and/or antibody control. It's also helping to remodulate the glutamate now thought to be behind OCD behaviors.

[T_Mom]

WOW! Great find.

Wouldn't it be something if this is the end of OCD for all--fascinating.

 

Thank you--We should send this to every psych we have ever seen with our PANDAS children!!!

[smartyjones]

I Another exciting new treatment possibility is raised by a recent study revealing the unexpected finding that B-lactam antibiotics increase the expression of glutamate transporters on glia and have neuroprotective effects in a mouse model of ALS. .

 

i do occasionally wade into the scientific discussions where i know i have no business being but . . .

 

so very odd, mom - b/c i just again picked up cure unknown today after misplacing it for a number of weeks -- i was reading about a man misdiagnosed - or perhaps not fully diagnosed - with ALS - possibly induced by lyme that had remarkable results from iv rocephin. the patient was a dr and he and his dr both theorized that perhaps the rocephin 'had been found to stimulate a gene that limited the amount of a neurotransmitteer called glutamate. excess glutamate at the nerve ending had been tied to ALS and suppression of the molecule was one theorized treatment of the disease.'

i believe others did not have such good results as this one guy.

 

mom - what are your plans with supplementation? are you increasing glutamate or trying to decrease it's action? i don't really understand what it does.

[MomWithOCDSon]

I Another exciting new treatment possibility is raised by a recent study revealing the unexpected finding that B-lactam antibiotics increase the expression of glutamate transporters on glia and have neuroprotective effects in a mouse model of ALS. .

 

i do occasionally wade into the scientific discussions where i know i have no business being but . . .

 

so very odd, mom - b/c i just again picked up cure unknown today after misplacing it for a number of weeks -- i was reading about a man misdiagnosed - or perhaps not fully diagnosed - with ALS - possibly induced by lyme that had remarkable results from iv rocephin. the patient was a dr and he and his dr both theorized that perhaps the rocephin 'had been found to stimulate a gene that limited the amount of a neurotransmitteer called glutamate. excess glutamate at the nerve ending had been tied to ALS and suppression of the molecule was one theorized treatment of the disease.'

i believe others did not have such good results as this one guy.

 

mom - what are your plans with supplementation? are you increasing glutamate or trying to decrease it's action? i don't really understand what it does.

 

Smarty --

 

I don't really fit in scientific conversations, either, but with the help of DH, I'm trying. My understanding thus far is that, similar to dopamine in our PANDAS kids and those with other conditions like OCD, it's not a matter of having too little or too much; it's a matter of it not being properly regulated. What I recall from a "20/20" episode in which they interviewed the doctor at Case Western University who did the glutamate/OCD study, is that he put a couple of brain scans on display. The brain of the kid with OCD showed glutamate almost "coagulated" in a single sector of the brain (the caudate, which, interestingly, is the same sector of the brain that Swedo found to be inflamed in her PANDAS studies -- she showed a slide of it at the AO conference), while the brain of the "normal" kid showed glutamate in several sectors throughout the brain but a reduced amount in the caudate.

 

There's another study ("Glutamatergic Dysfunction in OCD" out of India) that concluded that "Our study provides preliminary evidence implicating glutamatergic excess in the pathopsychology of OCD."

 

So, in the end, I'm not certain that increasing or decreasing glutamate itself is going to help anything. But we do give DS NAC, which is also supposed to assist in the modulation of CNS glutamate (1,000 mg. daily). And, since DS is one of the kids on long-term Augmentin XR, I'm hoping that the preliminary research regarding B-lactam abx is accurate, too, as this might help him with respect to getting the glutamate better proportioned (i.e., out of his caudate, gosh darn it!)

[tpotter]

So, I'm trying to make sense of what you wrote. Are you giving 1000 mg of NAC daily to your son? If so, are you finding that it is helping?

[trggirl]

I found this study which I think could be important to this discussion.

 

http://www.ncbi.nlm.nih.gov/pubmed/2154695

[MomWithOCDSon]

So, I'm trying to make sense of what you wrote. Are you giving 1000 mg of NAC daily to your son? If so, are you finding that it is helping?

 

Yes. As to its efficacy, frankly, it's hard to tell because we started this several months ago, along with abx. It is relatively inexpensive, and I know it's not hurting, so we continue it. I'd be interested in hearing from folks who haven't tried it previously and give it a trial as an "individual" add-on. I know there are historical threads here of people who've found it to be helpful, which is what led us to try it initially.

[MomWithOCDSon]

I found this study which I think could be important to this discussion.

 

http://www.ncbi.nlm.nih.gov/pubmed/2154695

 

Yes. I believe this is part of Cunningham's research. PANDAS kids have increased/high CamKII, which, per this abstract, "increases the initial rate of induced release of two neurotransmitters, glutamate and noradrenaline. These results support the hypothesis that activation of Ca2+/CaM-dependent PKII in the nerve terminal removes a constraint on neurotransmitter release."

[MomWithOCDSon]

This might be interesting to some of you. Here's a link with a slide from the television program I saw several months ago; I didn't get much of the details right (it wasn't "20/20," it was "Primetime Live," and it wasn't Case Western, it was Wayne State . . . oh well!). But I did fairly accurately remember the MRI images of a 9-year-old boy diagnosed with OCD versus a "control" 9-year-old boy.

 

The circled area on the images is the caudate (Wiki has some good info on this sector of the brain), and you can see the greater levels of glutamate in the OCD brain as compared to the normal brain. I wish I had a copy of Swedo's presentation from AO so that I could put the images up next to one another!

 

MRI - OCD Brain Caudate and Glutamate

[MomWithOCDSon]

Okay . . . now I'm obsessing about this.

 

Here's a story regarding Wayne State's research project. Check out this paragraph, in particular:

 

The studies found significant associations between glutamate receptor and transporter genes and abnormal brain volumes in brain regions implicated in OCD such as the thalamus ('grand central station' in the brain), caudate nucleus (brain's secretary), anterior cingulate cortex (brain's arousal center) and orbital prefrontal cortex (brain's executive decision maker).

 

Wayne State Glutamate and OCD Study