Section Review Central & Peripheral Nervous Systems: α₁-Adrenoceptor antagonists as treatments for benign prostatic hyperplasia

Abstract

α₁-Adrenoceptor antagonists, originally targeted towards hypertension, are being increasingly used in the treatment of benign prostatic hyperplasia. The identification of multiple α-adrenoceptor subtypes has resulted in the development of compounds which selectively target prostatic α-adrenoceptors and, therefore, provide the potential to produce greater symptomatic relief than non-selective agents. Current opinion suggests a predominant role for the α₁ A-adrenoceptor subtype in contracting human prostate smooth muscle, although more recent data suggest that a different, but closely related, subtype (α₁L) may be responsible. A number of agents have high affinity for prostatic α-adrenoceptors and selectively reduce prostatic urethral pressure in the absence of overt haemodynamic changes in various animal models. Newer compounds, such as Rec 15/2739 (SB 216,469), SL 89.0591 and SNAP 5089, may offer a potential advantage over existing agents, and prostate-selective α-adrenoceptor antagonists are progressing through to clinical studies.