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NSAIDs

Oral nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be beneficial for PANS/PANDAS patients. The medications appear to be particularly useful for exacerbations (or “mini-flares”) which occur in the weeks following immunotherapy. Assuming that the PANS and PANDAS condition is the result of an immune system disorder, reducing inflammation would have a beneficial effect for patients. Dosing levels are provided on the manufacturer’s label and by the PANS/PANDAS Research Consortium published guidelines. The cyclo-oxygenase inhibitor, celecoxib, is another NSAID that has been reported to be helpful. Mechanisms of action are unknown. All the NSAIDS carry risks of GI bleeding and other side effects, so they should be used with caution, following manufacturers’ guidelines for dosage and duration of therapy. See the PANS/PANDAS treatment flowchart for additional information.