Alpha Blockers

Alpha Blockers are some of the oldest drugs on the market for treating hypertension. The first FDA approval for them was the same year the first diuretic got approved, 1953. The name of the first alpha blocker was Dibenzyline, and it’s generic is phenoxybenzamine. Just like the first generation beta blockers these drugs are considered to be non-selective. They work by decreasing nerve ending activity in the brain, they block the neurotransmitter response of stimulating the nerve endings which are responsible for excreting the norepinephrine hormone. These drugs are used to treat/manage a number of other conditions besides hypertenison, and this list includes PTSD, Benign prostatic hyperplasia, Congestive heart failure, Raynaud's disease, Pheochromocytoma, erectile dysfunction, and coronary artery disease. It is important to note that alpha blockers are very strong drugs, they are often given to people who are admitted to the hospital with a hypertensive crisis. They are rarely prescribed to someone with uncomplicated hypertension anymore. In this article we will dive into how effective they are, how they make you feel, and of course, what the side effects are both right away and after a couple months of taking them.

It is important to note the difference between beta blockers and alpha blockers. Beta blockers hinder the body’s ability to create epinephrine (adrenaline). Alpha blockers inhibit the body from being able to produce norepinephrine. Both these hormones are produced by the adrenal gland, and are very similar in their chemical structure.

Alpha blockers are usually not the first line of treatment in patients with uncomplicated hypertension because of there potency. In fact, here at bloodpressureauthority we think this is a poor choice of drug for uncomplicated hypertension. They are often more of a last resort if a patient is not responding to other more mild drugs to lower blood pressure. Alpha blockers are strong, there is no getting around it. For lowering blood pressure, the do work well. Almost too well. Blood pressure can decrease at a rapid rate after taking alpha blockers. When administered at a higher dosage they can drop systolic pressure by up to 60 points. Yes, you read that right. 60 points. And the diastolic can go down as much as 40 points. Obviously these are median numbers created from data based on multiple patient experiences, and results will vary from patient to patient. If administered in a hypertensive crisis, the dosage given by a physician will be much higher than if prescribed as a maintenance dose for a patient. Alpha blockers are usually not prescribed in the event of a heart attack due to the fact that they can raise the heart rate.

The effects on the adrenal gland from alpha blockers can be severe. This is why some patients taking this drug for an extended period of time may experience depression and mood disorders, similar to the negative effects of beta blockers on a patients mental well-being.

Alpha blocker side effects can vary greatly from individual to individual. There is a limited amount of data on them in comparison with other hypertensive drugs, but side effects may include nightmares, insomnia, dizziness, headache, blurred vision, weakness, nausea, feeling faint, fainting, racing heartbeat, feeling of heart pounding, a high resting heart rate, fatigue, breathlessness under exertion, breathing problems, weight gain, anxiety, jitteryness, rebound hypertension, flu like symptoms, nasal congestion, general feeling of unwellness, mood changes, erectile dysfunction, increased risk of heart attack, and an increased risk for heart failure.

Like calcium channel blockers, alpha blockers increase a patients resting heart rate. This may in turn makes the patient feel like their heart is racing, especially with higher dosages of the drug. And in addition to this there is another bad side effect of the tachycardia, and that is an increased risk of heart attack. Heart attacks are usually brought on by plaque deposits either breaking off and blocking an artery, or building up so much blood can no longer flow through the artery. With alpha blockers making the heart beat faster, this can in turn trigger a heart attack easier in the right clinical setting.

Headaches are very common with alpha blockers. This is because blood vessels sizes in the brain can often be increased greatly when an alpha blocking drug is in the patients system. They can increase so much that it can cause discomfort. Think of when a person drinks coffee everyday, then they stop abruptly. They are going to get a headache for the same reason essentially. Because caffeine is a vasoconstrictor, and without it the size of the blood vessels change dramatically. This may also bring up the issue of early on-set dementia, as we have seen in the past with long term usage of other drugs which modify the size of the blood vessels in the brain.

Dizziness when taking alpha blockers can be extreme for some people. There have even been reports of people fainting, however it is hard to tell if the fainting was from the dizziness alone, from the drug itself, or from the very aggressive drop in blood pressure. It is important to take precautions when using these drugs. Make sure to not operate machinery or put yourself in any possibly dangerous situations which would require coordination. At least until you know how the drug is going to effect you.

One of the worst long term side effects of taking alpha blockers is heart failure.

Alpha blockers are potent vosdilators, they are similar to central agonists in their vasodilation effects. As with any potent vasodilator, this causes areas of the body to have enlarged blood vessels that were not designed for this great increase in size. Alpha blockers have been shown in a few studies to cause heart failure with long term use, or worsen heart failure if you already have it. This is due to the fact that alpha blockers are believed to enlarge almost everything in the cardiovascular system, including all areas around the heart. In one study these drugs caused a %25 higher cardiovascular disease state in comparison with diuretic therapy in the same clinical setting.

The heart needs a certain amount of tension on the valves and chambers. Also seen with beta blockers, when a drug modifys the hearts ability to work the way it was designed to, it can lead to heart failure. The heart walls can become thickened or thinned as a result. It is important to note that this is mainly seen with long term use only, but it can worsen heart failure in a short period of time if a patient already has it before starting the drug.