Did Bad On Midodrine? Dont Automatically Discount Other Pressors

[ramakentesh]

Ive been thinking about vasoconstrictors and specifically midodrine.

I know some (perhaps many) that do well on midodrine. Some take it as a combo with beta blockers or florinef. I took it and expected it to be great. But I found that the first dose made me heaps worse rather than better, the second dose helped a little but I felt quesy the whole time and somewhat anxious.

As you know midodrine is a selective alpha 1 agonist. That is all it supposedly does - activate this one group of receptors and cause vasoconstriction.

So you can imagine my reservations when a doctor suggested psuedoephidrene. i assumed it would be more likely to cause anxiety or quesiness.

However I felt great on it. Like normal. Completely infact after an initial crappy feeling. Similarly when I tried butchers broom some years back it worked very well.

The major difference between midodrine and pseudoephidrene/butchers broom is their mode of action:

While midodrine simply activates alpha receptors assuming they are still there, pseudo stimulates the release of NE presynaptically allowing it to activate alpha 1 and alpha 2 receptors that are present depending on the vasculature location. Butchers broom on the other hand does stimulate some NE release but it also activates BOTH alpha 1 and alpha 2 receptors.

Different areas of the body are innerved with different vasoconstrictive receptors (endothelien 1 receptors, angiotensin II receptors, and many more).

However some data suggests that alpha 1 receptors are more specific for the peripheral areas (hands and feet and skin blood flow) whereas alpha 2 are more involved in stomach and central vasoconstriction.

In other words if you dont pool in your hands and feet, midodrine might not be as helpful as other vasoconstrictors.

Food for thought I hope.

[Relax86]

I might be making a return to midrodine. The veins in my hands have been pretty consistently pumped up, blue and burning. As the blood flows down into my digits it's not in my brain making me light headed and feeling like my head is gonna pop. I've had some pressure in the one foot I do have (Im an amputee). Haven't really checked my BP lately. I might track it a little for the next 2-3 days and if it's low - I'm jumping back on the Midro band wagon. I had good luck with it before in raising my BP which in turn lowered my HR.

Also, when I read about people using abdominal binders I almost can't breathe thinking about it. I have such a terrible tolerance to just having my arms crossed and resting on my belly in standing. Any abdominal pressure - even the wrong jeans makes my HR increase almost immediately. So I feel like I need peripheral help. Why?? I have no clue.

[ramakentesh]

i should correct the above statement - it is unclear how butchers broom vasoconstricts - it is theorised to operate via alpha 1 and 2.