Don't Get Cold Feet ... try Prazosin Raynaud's phenomenon is characterised by vasospasm of the peripheral arterial vasculature - notably

affecting the digits of the hands and feet. Usually pharmacotherapy comprises drugs acting on peripheral or central adrenergic receptors to block autonomic ganglion impulses. This is not always well tolerated by patients. 20 patients with progressive systemic sclerosis (PSS) and associated Raynaud's phenomenon received oral prazosin (1mg tid), a postsynaptic a,-receptor antagonist in vascular smooth muscle, for management of the Raynaud's phenomenon.

Patients were matched in pairs on the basis of the average skin temperature of their middle fingers and randomly assigned to one of 2 groups (prazosin, placebo) for 8 weeks then treatment was reversed in the ninth week for 4 further weeks.

In 19 of 20 patients, prazosin effectively reduced the incidence and severity of reported vasospastic episodes immediately. Within 1 week of initiating therapy the frequency of episodes had fallen by 50% in both groups, and therapeutic benefit persisted for at least 4 weeks after withdrawal of the drug. No significant side effects were reported, although prazosin caused a drop in diastolic BP (standing) which returned to normal following drug withdrawal. Surwit. R.S et al .. · Archives of Dermatology 120.' 329 (Mar 1984)

0156.2703/84/0414.0007/0$01.00/0 © ADIS Press INPHARMA® 14 Apr 1984 7