Dr. Adame's Western/Pharmaceutical Approach to PANDAS/PANS Care

Over the last 3 years, we have had the privilege of being part of the healing journey of over 40 children affected with PANDAS/PANS.

I begin with an in-depth diagnostic process, then blend holistic/non-pharmaceutical interventions with Western/Pharmaceutical treatments.

Below is a general overview of the Western/Pharma treatment algorithm.

Please keep in mind algorithms are starting points.

Each patient is a unique and highly complex individual.

I am ready to pivot and change course depending on the patient's response.

I also meet families where they are in their PANDAS journey and do not attempt to retry treatments that have not worked or caused harm in the past.

Finally, I believe in shared decision-making.

Western/Pharma

• PANDAS Physician Network Treatment Algorithm

• NSAIDs (short term)

• Antibiotics (tailored to history and lab results, short term)

• Steroids (tailored to history, exposure, previous response)

• IVIG (I order serial monthly infusions for one year, but the ultimate infusion pattern is determined by insurance approval, patient outcome, and family preference)

• Referral to ENT for tonsillectomy if not done already

• Low Dose Naltrexone

• Long-Term to reduce pain, reduce inflammation, modulate the immune system

• Order sent to compounding pharmacy

• Leucovorin

• I start with a low dose of 5-10 mg

• Typically max at around 20-25 mg

• FRAT test optional

• Turmeric to reduce inflammation

• Magnesium (at high doses to support stress reduction and sleep)

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• Algae-based Omega-3 with at least 1000 mg EPA/DHA combo

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• Plant-Based Vitamin D

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• Probiotics

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• Mold Detox/Anti-fungals if indicated by history or labs

• Binders such as Binder Blend

• Nanogreens

• Oral Anti-Fungals if no response

• Allergy Treatment Optimizing if indicated

• Allegra (less likely to cross the blood brain barrier)

• Flonase

• Quercetin

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• Boswellia

• Additional supplements based on lab results

• Iron

• MethylFolate

• Methyl B12

• Additional pharmaceuticals depending on needs, goals, additional diagnoses, and quality of life

• Anti-Depressants such as SSRIs

• Anxiety Meds

• Medications for Tics

• Sleep Aids

• Goal is to UNMEDICATE whenever possible with close medical supervision and support for a Veggies Over Pills outcome

Are you ready to join the Culver Peds PANDAS/PANS Clinic? The first step is to register for a group info session to determine if we are the right practice for your child.

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