Anxiety and depression are commonly seen. Psychosis is seen in some patients but not very common. A consultation with a psychiatrist is recommended. Anxiety and depression are treatable in standard way. Cognitive function is usually normal in patients with Wolfram syndrome, especially in younger patients.
Headache may be related to autonomic dysfunction or neuropathy. Some patients experience sharp and stabbing unilateral pain similar to trigeminal neuralgia. A consultation with a neurologist is recommended. Carbamazepine or amitriptyline has been shown to be effective in some patients.
Autonomic neuropathy is commonly seen in patients with Wolfram syndrome. Signs and symptoms include orthostatic hypotension, anhidrosis, hypohidrosis, hyperhidrosis, constipation, gastroparesis, hypothermia, and hyperpyrexia. A thorough history and review of systems may reveal most of these complaints. Gastrointestinal conditions can be managed by changes in diet, small frequent meals, increased fiber diet, and increased water intake.
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