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Re: Adding Parnate and prazosin. » ed_uk2010

Posted by SLS on February 6, 2012, at 7:40:25

In reply to Re: Adding Parnate and prazosin. » SLS, posted by ed_uk2010 on February 6, 2012, at 6:31:13

> Thanks for the information Scott.
>
> >I see that Fanapt acts like prazosin at the NE alpha-1 receptor. Interesting.
>
> A large number of psych meds are alpha-1 blockers, especially TCAs and many APs (both old and new). This can cause orthostatic hypotension, dizziness and fainting/syncope. Alpha-1 antagonism isn't often thought of as a positive feature of psych meds, but I suppose it could be in some cases.

I think it depends on the subtype of NE alpha-1 receptor that occurs in the brain compared to peripherally. TCA probably does not hit the right receptors in the brain.

"More recently, three subtypes of the alpha1-receptor, the alpha1A, alpha1B and alpha1D have been isolated, cloned and characterized"

http://www.mc.uky.edu/pharmacology/instruction/pha824ar/pha824ar.html

"Prazosin antagonizes phenylephrine (alpha1 agonist)-induced contractions, in vitro, and binds with high affinity to the alpha1c adrenoceptor, which is thought to be the predominant functional type in the prostate."

* Note: The NE alpha-1c receptor has been renamed to NE alpha-1d.

* Note: Prazosin is non-selective and hits all NE alpha-1 receptor subtypes, albeit with differing binding affinities.

http://www.drugbank.ca/drugs/DB00457

For a review:

http://www.nature.com/mp/journal/v8/n7/full/4001351a.html


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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