Acute PGAD-Like Genital Arousal in a 59-Year-Old Woman After Duloxetine Withdrawal: A 36-Month Follow-Up Case Report

We report the case of a 59-year-old woman who experienced an acute episode of genital arousal symptoms consistent with Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD), but not fulfilling the duration criterion. The patient had several comorbidities known to be associated risk factors for PGAD/GPD. The most plausible contributing factor was the recent self-initiated cessation of duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI) prescribed for a mixed anxiety-depressive disorder. She was managed with rapid multidisciplinary assessment and short-term intravenous clorazepate and amitriptyline, together with analgesics, while the episode remained self-limited and resolved spontaneously within 5 hours after admission. This case aims to raise awareness among clinicians about acute PGAD-like genital arousal episodes potentially associated with antidepressant withdrawal, the need to carefully review medication histories, and the high level of distress and even suicidality that may accompany these symptoms.