From obsessions, compulsions, and tics, to personality changes and oppositional behavior, the symptoms of PANS are wide-ranging. PANDAS is considered a subset of PANS that is temporally associated with a Group A streptococcal (GAS) infection.

Emotional stress can trigger an inflammatory cascade response and increase blood levels of proinflammatory cytokines—including IL-1, IL-6, and tumor necrosis factor (TNF-α). These same inflammatory markers intensify in acute episodes of depression and mania.

Many of the medications we prescribe, most notably antipsychotics and antidepressants, have some risk of QTc prolongation. Since it’s rare to have complications of a prolonged QTc interval—such as torsades de pointes (TdP) and sudden cardiac death—clinics and hospitals typically don’t screen for it using electrocardiograms (ECG).

It’s well established that long-term, heavy alcohol use can damage the brain and can cause problems such as Wernicke-Korsakoff syndrome and alcohol-related dementia. But what about the vast majority of our patients, who drink moderately?

The mainstay of current treatment for panic disorder involves SSRIs and psychotherapy, specifically either cognitive behavioral therapy (CBT) or exposure with response prevention (ERP) therapy. Several studies have evaluated whether adding DCS to ERP therapy might enhance the effectiveness of the therapy, but there have been mixed results.

Tourette’s disorder (TD) is a movement disorder emerging during childhood that causes persistent motor and vocal tics. TD is treated with a variety of medications, but often with an off-label designation.