Persistent Genital Arousal Disorder: A Review of Its Conceptualizations, Potential Origins, Impact, and Treatment

Jackowich, Robyn A.; Pink, Leah; Gordon, Allan; Pukall, Caroline F.

doi:10.1016/j.sxmr.2016.06.003

Cited by 55 publications

(41 citation statements)

References 33 publications

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“…20 On the other hand, antidepressant initiation and particularly nefazodone, citalopram, buproprion, paroxetine, venlafaxine, trazodone and fluoxetine have been reported to trigger PGAD symptomatology. 5,6,[21][22][23] Proposed mechanisms include increased clitoral volume and vasoengorgement (especially with trazodone), 23 increased angiogenesis that follows antidepressant medication, 21 but still the exact mechanism that antidepressants may trigger PGAD remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…After the clinical evaluation, it was explained to her that her symptoms could be attributed to an identified disorder named PGAD. Since atypical antipsychotics have been discussed in the literature and have been used as therapeutic agents for PGAD, 5,6 the patient was advised to start receiving quetiapine 25 mg twice a day and was advised to gradually increase the daily dose to 100 mg. Remission of the abovementioned symptoms took place when quetiapine was increased to 50 mg twice a day. After a week of the cessation of the symptoms, she visited a psychiatrist in private practice, who stopped quetiapine due to its sedative action during the day, which the patient could not tolerate.…”

Section: Case History (Table 1)mentioning

confidence: 99%

“…3,4 It is still unclear whether its etiology is central or peripheral, since due to its low frequency most of the literature on the topic is based on case reports, suggesting multiple etiologies as well as therapeutic interventions. [5][6][7][8][9] More specifically, regarding possible etiologies, psychological entities (e.g. history of sexual abuse, comorbidity with depression or anxiety), vascular changes (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…small-fiber neuropathy theory), relationship with restless legs syndrome, as well as several pharmacologic agents (their initiation as well as their cessation), have been discussed by several authors in the literature. 5,6,10,11 In any case, most commonly, PGAD is a distressing condition, which may even lead to social isolation or suicidal ideation. 8 Multiple therapeutic interventions have been proposed, but since no specific cause identification exists, similarly no therapeutic algorithm exists.…”

Section: Introductionmentioning

confidence: 99%

“…risperidone, quetiapine). [5][6][7][8]12 Zolpidem is a non-benzodiazepine indirect GABA A receptor agonist. Its sedative-hypnotic and anticonvulsive activities seem to be due to its action on a1-GABA A receptors and not on the rest of GABA A receptors (a2 or a3).…”

Section: Introductionmentioning

confidence: 99%

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Zolpidem related persistent genital arousal disorder: An interesting case

et al. 2020

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T he present paper is describing a case of persistent genital arousal disorder that developed to a 55-year-old woman, shortly after the initiation of zolpidem. Persistent genital arousal disorder (PGAD) is a clinical entity that appears with a relatively low frequency in women, and is characterized by persistent or recurrent, unwanted and bothersome feelings of genital arousal, which often do not resolve with orgasm and are not associated with sexual desire (sexual interest, thoughts or fantasies). Women who experience PGAD often have feelings of shame, guilt and distress. Although its exact etiology remains unclear, various etiological factors have been proposed, central or peripheral, which may be psychological, vascular, dietary, pharmacological or neurological. Additionally, its presence has been associated to restless legs syndrome and overactive bladder syndrome. Likewise, multiple therapeutic interventions have been proposed and tried in patients with PGAD, either pharmacological (SSRIs, SNRIs, antiandrogens, benzodiazepines, antipsychotics, anticonvulsive agents) or other (ECT, physiotherapy, psychotherapy, nerve stimulation). Zolpidem is a nonbenzodiazepine indirect GABA A receptor agonist, which has lately been used as a therapeutic agent for PGAD in some cases. Nevertheless, in our patient, receiving zolpidem for insomnia seemed to be timely connected to the onset of PGAD symptomatology. The aim of the present paper is to highlight the need for more research into the possible factors that may contribute to PGAD.

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