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CURRENT ADR NETWORK REPORT

Persistent genital arousal with SSRIs?

A young woman stopped taking the antidepressant fluvoxamine (FEVARIN, generics) after several years of treatment and experienced persistent genital arousal as a result, which she has been suffering from for more than one year at the time this was reported (NETZWERK report 17.398). The reporting doctor is aware of corresponding events in connection with escitalopram (CIPRALEX, generics) as well a selective serotonin reuptake inhibitor (SSRI) like fluvoxamine. Persistent genital arousal disorder (PGAD) has almost exclusively been described in women. It is characterised by unwanted genital arousal with no feeling of sexual desire. It is sometimes painful in nature, can last for hours or even days and does not entirely disappear after an orgasm. It is not just sexual stimulation that can trigger or worsen the clinical picture, it can also be minor mechanical irritations such as vibrations when driving a car, or in some cases there are no identifiable triggers. The persistent arousal is experienced by the women affected as being highly problematic. PGAD is often linked to shame and can lead to social withdrawal and trigger suicidal thoughts (1, 2). In addition to psychological causes, central or peripheral neurological changes or disorders of circulation regulation analogous with priapism are being discussed as possible pathomechanisms. The women affected have varicose veins in the legs or pelvis, restless legs or an overactive bladder to a noticeably common extent (1, 2). Particularly antidepressants have been linked to persistent arousal as a side effect. In an internet survey, women reported that their symptoms started while they were taking fluoxetine (e.g. FLUOXETIN STADA) or following discontinuation of venlafaxine (TREVILOR, generics) or sertraline (ZOLOFT, generics) (3). The adverse effect has also been described following the discontinuation of citalopram (CIPRAMIL, generics) (2). On the other hand, the serotonin-noradrenaline reuptake inhibitor duloxetine (CYMBALTA, YENTREVE, generics) used for stress incontinence and diabetic neuropathy has also been used to treat PGAD in individual cases (1, 2). Please inform our NETZWERK DER GEGENSEITIGEN INFORMATION (NETWORK OF MUTUAL INFORMATION) if PGAD has occurred in combination with medical treatment.

1PHILIPPSOHN, S.: Sexuologie 2011; 18: 48-56
2de MAGALHÃES, F.J.C., KUMAR, M.T.: J. Clin. Psychopharmacol. 2015; 35: 352-4
3LEIBLUM, S.R., GOLDMEIER, D.: J. Sex Marital Ther. 2008; 34: 150-9

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