When OCD, anxiety, or food restriction appears overnight in a child, that’s a different clinical problem—and it requires a different lens.
In this episode, we sit down with Dr. Lindsey Wells to walk through how to recognize and approach PANS and PANDAS in practice. We focus on the hallmark presentation: abrupt-onset neuropsychiatric symptoms, often with a clear “before and after” that families can describe in detail. From there, the conversation shifts to what may be driving that change—whether that’s infection, immune activation, inflammation, or broader system vulnerability.
We also get practical. What does an initial workup look like? How do you think about common triggers like strep or other infections? When do you stay with foundational labs versus expanding further? And how do you support families who are often dealing with a sudden and destabilizing shift in their child’s behavior?
This episode is for clinicians who want a clearer, more grounded way to recognize PANS and PANDAS—and to start thinking through these cases without overcomplicating or overinterpreting limited evidence.
Dr. Lindsey Wells is a naturopathic physician specializing in pediatric PANS and PANDAS. Her clinical work focuses on identifying potential infectious and immune contributors to abrupt-onset neuropsychiatric symptoms while supporting long-term stabilization. She is also the author of Super Sam and the Battle Against PANS/PANDAS, a children’s book designed to help families, siblings, and educators better understand these conditions.
00:00 – PANS/PANDAS overview
02:03 – How to explain PANS/PANDAS to families
06:33 – What is PANS? What is PANDAS? Diagnostic criteria and symptom clusters
10:20 – Why PANS/PANDAS is often missed
14:06 – How is PANS diagnosed?
18:37 – What causes PANS/PANDAS? Infection triggers, immune response, and neuroinflammation explained
24:55 – PANS/PANDAS treatment approaches: antimicrobials, anti-inflammatories, and symptom support
27:11 – Using anti-inflammatory trials in PANS: when ibuprofen response may inform clinical direction
34:02 – Can teens or adults have PANS/PANDAS?
41:38 – Long-term management of PANS/PANDAS: preventing flares and supporting immune resilience
This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care.
The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.