Improvement in the level of psychosocial functioning in chronic pain patients with the use of risperidone.

Overview

Psychiatric morbidity is a common complication of chronic pain. Psychopathology may lead to psychosocial dysfunction and poor prognosis for rehabilitation. Emotional factors associated with chronic pain may include depression with anxious and angry affect. Antidepressant medication is a common adjuvant pharmacological treatment in the chronic pain patient. While uncomplicated depression may respond well to antidepressants, some cases are treatment resistant. We present two cases of chronic pain patients with associated depression with angry affect that did not respond to conventional treatment. Addition of the atypical antipsychotic risperidone resulted in symptomatic improvement and higher levels of psychosocial functioning. Atypical antipsychotics may be useful in selected patients with chronic pain and treatment-resistant depression.