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Korda JB et al. – Based on the patient's bipolar disorder, the mechanism of action of ECT and the observation of ECT effectiveness on her PGAD, authors hypothesize that bipolar disorder led to central hyperactive dopamine release, an important component in the pathophysiology of her PGAD; central serotonin deficiency after selective serotonin–reuptake inhibitor (SSRI) withdrawal resulted in a lack of inhibition of sexual excitement; ECT resulted in lowering of the hyperstimulated central dopamine release; and ECT led to an increase in sexual inhibition by stimulating serotonin activity.

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