Skip to main content
PMC home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1986 Aug;78(2):576–581. doi: 10.1172/JCI112611

Use of alpha 2 adrenoreceptor agonists and antagonists in the functional assessment of the sympathetic nervous system.

D Robertson, M R Goldberg, C S Tung, A S Hollister, R M Robertson
PMCID: PMC423596  PMID: 3734105

Abstract

We studied the effects of clonidine, an alpha 2-adrenoreceptor agonist, and yohimbine, an alpha 2-adrenoreceptor antagonist, on blood pressure, heart rate, and plasma catecholamines in 12 patients with autonomic dysfunction. Clonidine (0.1 mg, orally) lowered blood pressure 18 +/- 3 torr in six subjects and raised it 5 +/- 1 torr in six. The change in blood pressure in response to this dose of clonidine was inversely proportional to the supine level of norepinephrine (P less than 0.05). Yohimbine (4-64 micrograms/kg) raised plasma norepinephrine and blood pressure in six patients with degenerative autonomic dysfunction. Yohimbine also attenuated by 50% (P less than 0.05) the hypotensive response to head-up tilt of patients with degenerative autonomic dysfunction. Clonidine depends upon postjunctional hypersensitivity and the degree of autonomic insufficiency to elicit its pressor response. In contrast, the pressor response to yohimbine is related to the capacity of the sympathetic nervous system to be activated and release norepinephrine. If plasma norepinephrine levels following yohimbine administration are monitored, the biochemical and hemodynamic response to the drug may provide a sensitive indication of the capacity of the sympathetic nervous system to be activated in patients with autonomic dysfunction.

Full text

PDF
579

Images in this article

579Image
on p.579

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brodde O. E., Anlauf M., Arroyo J., Wagner R., Weber F., Buck K. D. Hypersensitivity of adrenergic receptors and blood-pressure response to oral yohimbine in orthostatic hypotension. N Engl J Med. 1983 Apr 28;308(17):1033–1034. doi: 10.1056/NEJM198304283081717. [DOI] [PubMed] [Google Scholar]
  2. Charney D. S., Heninger G. R., Sternberg D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci. 1982 Jun 7;30(23):2033–2041. doi: 10.1016/0024-3205(82)90444-1. [DOI] [PubMed] [Google Scholar]
  3. Elizur A., Liberson Z. An acute psychotic episode at the beginning of clonidine therapy. Prog Neuropsychopharmacol. 1980;4(2):211–213. doi: 10.1016/0364-7722(80)90039-9. [DOI] [PubMed] [Google Scholar]
  4. Enoch M. D., Hammad G. E. Acute hallucinosis due to clonidine. Curr Med Res Opin. 1977;4(9):670–671. doi: 10.1185/03007997709115290. [DOI] [PubMed] [Google Scholar]
  5. Goldberg M. R., Hollister A. S., Robertson D. Influence of yohimbine on blood pressure, autonomic reflexes, and plasma catecholamines in humans. Hypertension. 1983 Sep-Oct;5(5):772–778. doi: 10.1161/01.hyp.5.5.772. [DOI] [PubMed] [Google Scholar]
  6. Goldberg M. R., Robertson D. Yohimbine: a pharmacological probe for study of the alpha 2-adrenoreceptor. Pharmacol Rev. 1983 Sep;35(3):143–180. [PubMed] [Google Scholar]
  7. Kobinger Central alpha-adrenergic systems as targets for hypotensive drugs. Rev Physiol Biochem Pharmacol. 1978;81:39–100. doi: 10.1007/BFb0034091. [DOI] [PubMed] [Google Scholar]
  8. Laufer S. T. Orthostatic Hypotension: (Report of a Case). Can Med Assoc J. 1942 Feb;46(2):160–164. [PMC free article] [PubMed] [Google Scholar]
  9. Onrot J., Goldberg M. R., Biaggioni I., Hollister A. S., Kingaid D., Robertson D. Hemodynamic and humoral effects of caffeine in autonomic failure. Therapeutic implications for postprandial hypotension. N Engl J Med. 1985 Aug 29;313(9):549–554. doi: 10.1056/NEJM198508293130905. [DOI] [PubMed] [Google Scholar]
  10. Polinsky R. J., Kopin I. J., Ebert M. H., Weise V. Pharmacologic distinction of different orthostatic hypotension syndromes. Neurology. 1981 Jan;31(1):1–7. doi: 10.1212/wnl.31.1.1. [DOI] [PubMed] [Google Scholar]
  11. Robertson D., Goldberg M. R., Hollister A. S., Wade D., Robertson R. M. Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. Am J Med. 1983 Feb;74(2):193–200. doi: 10.1016/0002-9343(83)90607-1. [DOI] [PubMed] [Google Scholar]
  12. Robertson D., Goldberg M. R., Onrot J., Hollister A. S., Wiley R., Thompson J. G., Jr, Robertson R. M. Isolated failure of autonomic noradrenergic neurotransmission. Evidence for impaired beta-hydroxylation of dopamine. N Engl J Med. 1986 Jun 5;314(23):1494–1497. doi: 10.1056/NEJM198606053142307. [DOI] [PubMed] [Google Scholar]
  13. Robertson D., Hollister A. S., Carey E. L., Tung C. S., Goldberg M. R., Robertson R. M. Increased vascular beta2-adrenoceptor responsiveness in autonomic dysfunction. J Am Coll Cardiol. 1984 Mar;3(3):850–856. doi: 10.1016/s0735-1097(84)80264-8. [DOI] [PubMed] [Google Scholar]
  14. Thomas J. E., Schirger A., Fealey R. D., Sheps S. G. Orthostatic hypotension. Mayo Clin Proc. 1981 Feb;56(2):117–125. [PubMed] [Google Scholar]
  15. Ziegler M. G., Lake C. R., Kopin I. J. The sympathetic-nervous-system defect in primary orthostatic hypotension. N Engl J Med. 1977 Feb 10;296(6):293–297. doi: 10.1056/NEJM197702102960601. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES