74: Dr. Scott Antoine: Why PANS and PANDAS are leading hidden causes of mental illness in children

In this vital and technically complex presentation, Dr Scott Antoine explains why PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptoccocal Infection) are common and overlooked root cause of psychiatric symptoms in children (such as OCD, restrictive eating, anxiety, emotional distress, depression, dramatic mood swings, psychosis and suicidal ideation). In doing so, he encourages physicians to explore mental health in an entirely new way, especially in the treatment of children. 

Dr Scott Antoine completed his undergraduate training at the University of Scranton, after which he completed his doctorate at the Philadelphia College of Osteopathic Medicine. He later served in active duty with the United States Army as an Emergency Physician and worked as an Emergency Physician at St. Francis Hospital until 2019. In addition to his board certification in Emergency Medicine, he achieved board certification in Integrative Medicine and holds certifications in Functional Medicine through the Institute for Functional Medicine (IFM) and A4M. His book The Comprehensive Physicians Guide to the Management of PANS and PANDAS was released in February 2024 to excellent reviews. 

He discovered his calling when he and his wife Ellen, also a Functional and Integrative Medicine physician, battled to correctly diagnose the root-cause of their 12 year old daughter’s sudden-onset OCD, insomnia, rage, as PANS. Since then, he has helped hundreds of children recover from PANS and PANDAS, and in 2019 helped to pass a law which prohibits insurance companies in Indiana from denying coverage for medical care (including IVIG) for children with PANS and PANDAS.

In this richly informative personable interview, he presents an evidence-based outline of the successful ways to both diagnose and treat PANS and PANDAS, and stresses that they are not nearly as rare as mainstream medicine seems to believe. He decodes complex medical expertise, referencing over 300 clinical studies and peer-reviewed medical literature, that identify biological mechanisms and the root causes that underlie PANS and PANDAS. In this episode, Dr Antoine unravels why PANS/PANDAS can have such a profound, often sudden impact on Children’s psychiatric health, and demands that PANS and PANDAS be considered more broadly in psychiatric diagnoses. In this episode you will learn how infections, toxins and the immune system interplay in the expression of harmful psychiatric symptoms, why they cause PANS and PANDAS, and how they can be successfully treated.  

In this episode learn about:

• Why PANS and PANDAS are hidden and common root cause of OCD, violent mood swings, depression, anxiety and suicidality, how they are diagnosed, and the role of testing.

• Why physicians routinely overlook and even deny PANS and PANDAS as a cause of mental health symptoms.

• Why toxins and infections can trigger PANS and PANDAS and their associated neuropsychiatric symptoms.

• How Strep is related to autoimmunity and why to treat it even if strep tests are negative.  

• Why a range of infections - not just strep or Lyme borrelia - can trigger neuropsychiatric symptoms (OCD, attention issues, hallucinations, psychosis, depression, suicidal ideation), including other tick-borne co-infections, influenza, Epstein Barr, chlamydia pneumonia and Covid.

• Ways environmental chemicals, heavy metals, pesticides and mycotoxins (mould) can lead to inflammation and autoimmunity.

• The concrete link between rheumatic fever and OCD, ADHD, mood issues and psychosis.

• Other causes of autoimmunity, including genetics, intestinal permeability, infection/T-cell activation and molecular mimicry  (the mechanism by which microbes can induce autoimmunity).

• The 4 vital components of treatment: 1) find and treat infections 2) find and remove toxins 3) re-regulate the immune system 4) break neurological loops (OCD, anxiety).

• How to treat infections using prolonged use of antibiotics, and which antibiotics to choose.

• Why herbs (isatis, baicalensis, cat’s claw etc) can reduce the duration of antibiotic use, and the studies that prove it.

• The binders (activated charcoal, zeolites, humic acid) and bitters that help remove toxins.

• Ways medications (naltrexone and steroids) can help re-regulate the immune system.

• Why and when IVIG is used for the treatment, why it can relieve and cure symptoms (OCD, anxiety and tics) quickly.

• How Exposure Response Prevention (ERP) and hypnosis outperforms medications in breaking neurological loops (OCD, anxiety, intrusive thoughts)

• Other helpful interventions that assist healing; nutrients, diet changes and probiotics.