PANDAS symptoms improve with antidopaminergic pharmacotherapy
“Unfortunately, even with correct diagnosis and utilization of commonly prescribed pharmacotherapy and psychotherapy, medical management can often be ineffective at treating the neuropsychiatric symptoms,” the authors state.
In this article, investigators describe the case of a 15-year-old boy who developed intermittent behavioral changes that would occur several times a day. His symptoms centered around body dysmorphia with the patient becoming obsessed with fixed portions of food. He lost nearly 25 lbs.
“He would walk in circles in his room 100 times to the left and then 100 times to the right due to his obsession with burning calories.”
The symptoms emerged each time the patient developed a strep infection. Unfortunately, his symptoms were so severe that he needed to be temporarily homeschooled and was unable to continue playing hockey.
Multiple psychotropics resulted in “little to no relief from the psychiatric symptoms.”
The patient underwent antidopaminergic therapy that resulted in significant neurological and psychiatric improvement.
“The use of antidopaminergic pharmacotherapy to target the induction of D1 and D2 dopamine receptors was efficacious in this patient,” the authors state, “however, it warrants additional research with a larger sample to determine its effectiveness in the treatment of this psychiatric condition.
Given that the pathophysiology of PANDAS involves autoimmune induction of D1 and D2 dopamine receptors, “it is understandable why it would respond to a drug targeting this dopamine receptor activation.”
The authors point out:
“In this case, the patient not only did not respond to antibiotic therapy but also failed to respond to conventional psychotherapy with SSRIs. He did, however, respond exceedingly well to antidopaminergic pharmacotherapy.”
