Miyake Keita, Takaki Manabu, Sakamoto Shinji, Kawada Kiyohiro, Inoue Shinichiro, Yamada Norihito
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Clin Neuropharmacol. 2018 May/Jun;41(3):109-110. doi: 10.1097/WNF.0000000000000279.
Restless genital syndrome (RGS) includes discomfort, pain, numbness, vibration, restlessness, or a burning sensation involving the vagina, perineum, pelvis, penis, and proximal portion of the lower limbs in patients. The RGS has been sometimes reported in Parkinson disease. In patients without Parkinson disease, RGS is also known as persistent genital arousal disorder (PSAS), which includes uncontrollable genital arousal, with or without orgasm or genital engorgement, unrelated to sexual desire. Although withdrawal from selective serotonin reuptake inhibitors antidepressants is reported to induce PSAS, there is no report of RGS or PSAS induced by antidepressants.
We obtained the consent for the presentation and have not identified individuals for ethical reasons.
We first report a woman patient with depression induced RGS by milnacipran (MLN).
We discuss the relationship with restless legs syndrome and the difference from akathisia. It is highly possible MLN affected her RGS because she experienced RGS for the first time after the dose of MLN was increased. A limitation of this report is that we stopped MLN and administered gabapentin enacarbil immediately. We should join MLN to the list of compounds suspected of inducing RGS.
不安生殖器综合征(RGS)包括患者出现的不适、疼痛、麻木、振动感、不安或灼烧感,累及阴道、会阴、骨盆、阴茎及下肢近端。RGS有时在帕金森病患者中被报道。在无帕金森病的患者中,RGS也被称为持续性性唤起障碍(PSAS),包括无法控制的性唤起,伴有或不伴有性高潮或生殖器充血,与性欲无关。尽管有报道称停用选择性5-羟色胺再摄取抑制剂类抗抑郁药可诱发PSAS,但尚无抗抑郁药诱发RGS或PSAS的报道。
我们已获得病例展示的同意,且出于伦理原因未指明具体个体。
我们首次报告了1例米那普明(MLN)诱发抑郁症患者出现RGS。
我们讨论了其与不安腿综合征的关系以及与静坐不能的区别。很有可能是MLN导致了她的RGS,因为她在增加MLN剂量后首次出现RGS。本报告的一个局限性是我们停用了MLN并立即给予加巴喷丁恩卡比。我们应将MLN列入疑似诱发RGS的化合物名单。