(236) Flibanserin for Post-Orgasmic Illness Syndrome: A Case Report

Abstract Introduction Postorgasmic illness syndrome (POIS) is a rare disorder with ~50 cases recorded in the literature over last 10 years. POIS characterized by symptoms of flu-like fatigue, myalgias, fevers, mood disturbance, congestion, rhinorrhea and conjunctival pruritus, that begin within seconds to hours after an orgasm for duration 2-7 days. The most well described pathophysiologic hypothesis date immunologic based hypersensitivity reaction, but other hypotheses include withdrawal from endogenous opioids, dysregulated neuroendocrine response or autonomic nervous system. These mechanisms are elucidated patient responses different treatments including, antihistamines, dopamine agonists, benzodiazepines, NSAIDs SSRIs. However, no standardized treatment has yet been developed. Objective Here we describe case intractable physician, who had remarkable flibanserin nightly gabapentin pain. Methods Patient 40 year old male acquired post orgasmic started years prior. Symptoms headaches, muscle pain, numbness, weakness, irritability, low energy, anhedonia, brain fog. start 30 minutes every persist 1 week. He reports fluctuations his libido when experiencing these symptoms. Orgasms feel good him do not change POIS. Pre-ejaculate ejaculate trigger problems erections. tension headaches arousal which affect day he does experience full report issues stress except during nonsmoker up two drinks per month. denies trauma, general back injuries bowel dysfunction abnormal penile curvature. able reduce symptom week 4 days combination bupropion, lexapro, silodosin, ritalin, tramadol; however, intensity still significant. was trialed on gabapentin. advised take 200 mg 100 nightly. Results significantly improved patient's intensity. now experiences mild one stopped taking medications. also markedly improved, helping wife restore their intimate relationship. Conclusions use flibanserin, serotonin receptor 2A antagonist 1A partial agonist literature, supports role pathogenesis Serotonin known inhibitor sexual significant impact mood, memory cognition. As such this dysregulation could modulate many present including fog, anhedonia energy. variability medications provide relief patients emphasizes importance multidimensional individualized approach treating patients' distinct presentations. Disclosure No