Abstract
Patients with Ehlers-Danlos syndrome (EDS) have a higher prevalence of comorbid anxiety disorders. Due to the complex nature of these patients, there is often a delay in the diagnosis of these disorders as well as insufficient management of their anxiety symptoms. Current treatment options are often insufficient or poorly tolerated by patients, creating barriers to proper treatment. We hypothesized that patients with EDS and comorbid anxiety, who have failed multiple medication trials, may benefit from a trial of risperidone. In this case report, we discuss the successful management of treatment-resistant anxiety in a patient with EDS with the use of risperidone. Management of comorbid anxiety in these patients is essential, as untreated anxiety can result in increased somatic sensation sensitivity and poor social functioning. Once underlying anxiety disorders are addressed, patients with EDS can better cope with chronic pain symptoms and are more likely to build a therapeutic alliance with their treating physicians. This results in an improved prognosis, social functioning, and overall quality of life.
Highlights
Ehlers-Danlos syndrome (EDS) refers to a hereditary group of disorders that affect connective tissue matrix proteins
We hypothesized that patients with EDS and comorbid anxiety, who have failed multiple medication trials, may benefit from a trial of risperidone
Once underlying anxiety disorders are addressed, patients with EDS can better cope with chronic pain symptoms and are more likely to build a therapeutic alliance with their treating physicians
Summary
Ehlers-Danlos syndrome (EDS) refers to a hereditary group of disorders that affect connective tissue matrix proteins. A prior case report discussed the management of anxiety, depression, and borderline personality disorder in a 25-year-old female with EDS who was treated with sertraline 150 mg qd (once a day), gabapentin 600 mg BID (twice a day), and lithium 300 mg BID (to help augment SSRI and attempt to decrease suicidality). This patient’s anxiety symptoms persisted despite the use of medications [6]. She was discharged home with this prescription and arranged with outpatient psychiatric follow up
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