Hirose Yuki, Oda Yasunori, Kobayashi Tatsuya, Okada Kazuki, Iyo Masaomi
Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, JPN.
Department of Regulatory Science, Fujita Health University, Tokyo, JPN.
Cureus. 2023 Dec 11;15(12):e50349. doi: 10.7759/cureus.50349. eCollection 2023 Dec.
Although the symptoms of persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) can have negative impacts on patients' lives, it is an under-recognized clinical entity. We describe the case of a 61-year-old Japanese female who suffered simultaneously from bipolar disorder and PGAD/GPD. She developed PGAD/GPD approx. 10 years after being diagnosed with bipolar disorder. Despite 20 years of various drug treatments, her bipolar disorder and PGAD/GPD symptoms showed little improvement. She had also undergone multiple sessions of cognitive behavioral therapy (CBT) and mindfulness, nerve block, botulinum toxin injections, and laser treatment for PGAD/GPD. Her PGAD/GPD symptoms remained with no significant improvement, and her bipolar disorder symptoms had also not responded well to medication. With the administration of brexpiprazole, she achieved remission of her bipolar disorder. Her PGAD/GPD symptoms also eventually improved. When PGAD/GPD is comorbid with bipolar disorder, the improvement of bipolar disorder may also lead to relief of PGAD/GPD symptoms. This case reveals that brexpiprazole, which has a unique profile, may be effective for PGAD/GPD.
尽管持续性性唤起障碍/生殖器-盆腔疼痛障碍（PGAD/GPD）的症状会对患者生活产生负面影响，但它是一种未得到充分认识的临床病症。我们描述了一名61岁日本女性的病例，她同时患有双相情感障碍和PGAD/GPD。她在被诊断为双相情感障碍约10年后出现了PGAD/GPD。尽管接受了20年的各种药物治疗，她的双相情感障碍和PGAD/GPD症状几乎没有改善。她还接受了多次针对PGAD/GPD的认知行为疗法（CBT）和正念训练、神经阻滞、肉毒杆菌毒素注射以及激光治疗。她的PGAD/GPD症状依然存在，没有明显改善，而且她的双相情感障碍症状对药物治疗也没有良好反应。使用布雷哌唑治疗后，她的双相情感障碍实现了缓解。她的PGAD/GPD症状最终也有所改善。当PGAD/GPD与双相情感障碍共病时，双相情感障碍的改善可能也会导致PGAD/GPD症状的缓解。该病例表明，具有独特特性的布雷哌唑可能对PGAD/GPD有效。
