PEPSID for PANDAS

[minimaxwell]

Just wanted to post about a recent appt. with Dr Tim Buie (GI) from MGH Boston. He sees PANDAS kids and is VERY active in the world of Autism. He put my DD on a high dose of PEPSID not for any gi issues but for PANDAS. He wants her taking 40 mg BlD(twice a day), she is 100 lbs. He gave me an RX but turns out is what cheaper to buy it off the shelf at the drug store.

[beeskneesmommy]

Hi - this is not the 1st time I have read about this. I think we will give it a try, alsi because all of the abx are giving my son intermittent reflux. He is 1/2 that weight at 43lbs. I see Dr. Latimer on Wed. and I will ask her as well...thank you!

[EAMom]

Just wanted to post about a recent appt. with Dr Tim Buie (GI) from MGH Boston. He sees PANDAS kids and is VERY active in the world of Autism. He put my DD on a high dose of PEPSID not for any gi issues but for PANDAS. He wants her taking 40 mg BlD(twice a day), she is 100 lbs. He gave me an RX but turns out is what cheaper to buy it off the shelf at the drug store.

 

Interesting...did he also rec any H1 blocker antihistamines (zyrtec etc), or just H2 (pepcid)?

 

Let us know how it goes.

[minimaxwell]

No, we did not discuss H1. My dd used to get spontaneous hives all the time,especially if she was anxious or having a panic attack. She rarely gets them now after lVlG. We used to give her claritin daily but I never noticed it really did anything for her.

[MomWithOCDSon]

Nice to hear another medical recommendation for the H2 blocker. We've been dosing Pepcid (usually 20 mg. daily) for several months now and see good results, also. Good luck with your DD!

[MomWithOCDSon]

Minimaxwell --

 

Meant to ask before, how did the doctor suggest you dose the 40 mg. daily? Twice each day, or in one dose? Before meals, first thing in the morning, or at bedtime, etc.?

[Mayzoo]

My only real concern with this is strep is killed in the stomach by the higher acid level. Reduce the acid level and the strep is not killed as efficiently which may lead to a strep infection.

 

I will have to find the article for this later.

[StillHopeful]

Hi -- Does anyone know if you can buy Pepsid in capsule form? My DS won't chew the tablets due to the texture. Can it be Pepsid AC? I would assume that it is the active ingre. Famotidine that helps so will any brand do? Thought I might give this suggestion a try. Sorry for all the questions and thanks.

Edited October 22, 2012 by Ngold24

[minimaxwell]

She is taking 40 mg in AM AND 40mg PM.

[EAMom]

My only real concern with this is strep is killed in the stomach by the higher acid level. Reduce the acid level and the strep is not killed as efficiently which may lead to a strep infection.

 

I will have to find the article for this later.

 

http://general-medicine.jwatch.org/cgi/content/full/2006/110/2

one concern I have is that H2 blockers might make one more prone to C. Difficile:

 

Gastric-acid suppression has been associated with an increased risk for bacterial enteric infections such as salmonellosis, and several studies now suggest that it also heightens risk for CDAD. The biologic explanation for this association is not immediately clear, as the spore forms of C. difficile that are thought to transmit disease are acid-resistant, but other drug effects might be responsible. The association with NSAID use, if confirmed, also awaits explanation. Clearly, we have not yet even begun to understand the full biologic and behavioral story of CDAD, especially in the community.

[LNN]

Ngold24 - yes, Pepcid and generics come in a pill form. Generics are fine.

 

I know some people have seen positive results with the pepcid and I'm certainly all for experimenting. Just please be aware that you shouldn't take any antacids with abx - they can hinder abx absorption. Always look at the ingredients and google to check for issues.

 

Also, the common dose for this stuff is 10mg for an adult. 20mg/day is extra strength - for an adult. If you're going to experiment, go slow. My DD7 has been on 20mg Famotidine under a GI doc's care, but it was because her GERD and Dyspepsia were causing her to lose weight. Tiffani's DD (nearly an adult) is on a very high dose per a doctor's advice. But to try this as a histamine blocker for Pandas symptoms on your own, I think starting at 10mg would be a wiser course.

 

FWIW - when my DD was on Famotidine, it didn't really effect her behavioral symptoms one way or the other. It has helped GERD at times but there have also been times it didn't help much (low stomach acid can also cause GERD, not just high stomach acid). So I think it may be worth trying for your own child but it may not be the answer and as others have said, you should be mindful of possible downsides.

 

(sorry to be a wet blanket - just feeling cautious these days).

[minimaxwell]

lol, LLM you are never a wet blanket. It is always important to share both sides of the coin.

I did ask about the C Diff, he was not concerned as long as we kept up high dose of probiotics. Also asked him about rotating, he said find one that works and stick with it. Not sure how I feel about that.I have been rotating a little.

 

So, are you suggesting taking the Pepsid away from abx or just things like Tums away from abx? Also, we are starting Clindamycin today(she was on Aug and just finished 10 days of doxy) Wondering if I need to give Zinc away from this abx? I have asked a few pharmasists and keep getting different answers.

[LNN]

We rotate probiotics - we have three different blends that we rotate throughout the week. I'm sure there are different schools of thought, but that's what we do. I'd follow your own gut (no pun intended).

 

I was suggesting that you take anything with an antacid away from abx. I haven't looked at Pepcid. I don't think straight famotadine is a problem. We only gave it at night because DDs issue was Dyspepsia first thing in the morning. So the GI doc wanted it in her system before she woke up. We give abx at dinner time and gave the Pepcid at bedtime 2 hrs later. So I never bothered to look into whether timing was an issue because she took them apart from each other anyway.

 

I give zinc at the same time as abx because the abx my kids use don't show up on a list of abx that don't go well with zinc. So it's never been an issue in our house. But if it's any comfort, my LLMD tends to be a bit loose on timing of supplements, especially things that are found in foods (like zinc and other nutrients). he figures that you get nutrients from foods in sporadic doses throughout the day, so try not to stress over timing of supps. But you do raise a good point. If you can manage it, it might be better to separate them, especially if you're using one of the abx that interacts with zinc.