![]() Prazosin is commonly used as an anti-hypertensive, but because alpha-1 adrenergic activity has been connected to fear and startle responses, it sees use as a PTSD treatment. Post-traumatic stress disorder is a disabling mental condition that can develop following a traumatic experience for example, it is especially common in military veterans and sexual assault survivors. Post-traumatic stress disorder (PTSD) and nightmares In these studies, doxazosin was prescribed at the low dose of 1–2 mg. This approach also enables separate titration of alpha- and beta-blocking effects. Studies of combined oral alpha- and beta-blockade using an alpha-blocker (e.g., doxazosin or terazosin) in combination with a nonlipophilic beta-blocker with more reliable bioavailability (e.g., betaxolol, bisoprolol, atenolol and others) have shown a larger antihypertensive effect. This is supported by studies that show surprisingly though consistently that neither alpha- nor beta-blocker mono- therapy reduces sympathetically mediated blood pressure reactivity to acute experimental stressors. In patients with neurogenic hypertension who fail in achieving blood pressure control with angiotensin converting enzyme inhibitors (ACEi), Angiotensin receptor blockers (ARB) and calcium channel blockers (CCB), alpha- and beta- adrenergic receptor blockers constitute the main treatment options. BPH and hypertension are both very common in men over 60 years old. Doxazosin has been shown to improve symptoms of BPH in the elderly and reduce blood pressure at the same time. They are not thought to be good as first line treatment because there are other more selective agents, although they can be good for treating men with hypertension and BPH. Hypertension Īlpha-1 blockers are used as second line treatment for high blood pressure. Dutasteride and tamsulosin are on the market as combined therapy and results have shown that they improve symptoms significantly versus monotherapy. In some cases alpha-1 blockers have been used in combined therapy with 5-alpha reductase blockers. Later generation drugs in this class are used for this purpose. First generation alpha-1 blockers, like prazosin are not recommended to treat lower urinary tract symptoms because of their blood-pressure-lowering effect. They are all believed to be similarly effective for this purpose. Doxazosin, terazosin, alfuzosin, and tamsulosin have all been well established in treatment to reduce lower urine tract symptoms (LUTS) caused by benign prostatic hyperplasia. Alpha-1 blockers are first line treatment for the symptoms of BPH in men. Alpha-1 blockers are the most commonly used medicine to treat BPH. Medical uses Benign prostatic hyperplasia īenign prostatic hyperplasia (BPH) is an enlarged prostate gland. Drugs that act as selective antagonists at specific alpha-1 adrenergic receptor subtypes have also been developed. As of 2018, prazosin is the only alpha-1 blocker known to act as an inverse agonist at all alpha-1 adrenergic receptor subtypes whereas tamsulosin is a selective antagonist for all alpha-1 subtypes. Currently, several relatively selective alpha-1 antagonists are available. The first drug that was used was a non-selective alpha blocker, named phenoxybenzamine and was used to treat BPH. Over the last 40 years, a variety of drugs have been developed from non-selective alpha-1 antagonists to selective alpha-1 antagonists and alpha-1 inverse agonists. When alpha blockers bind to these receptors in vascular smooth muscle, they cause vasodilation. Alpha-1 adrenergic receptors are present in vascular smooth muscle, the central nervous system, and other tissues. They are mainly used to treat benign prostatic hyperplasia (BPH), hypertension and post-traumatic stress disorder. Alpha-1 blockers (also called alpha-adrenergic blocking agents or alpha-1 antagonists) constitute a variety of drugs that block the effect of catecholamines on alpha-1-adrenergic receptors.
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