Which medications in the drug class Alpha1 Agonists are used in the treatment of Multiple System Atrophy?

Updated: Oct 17, 2018
  • Author: André Diedrich, MD, PhD; Chief Editor: Selim R Benbadis, MD  more...
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Alpha1 Agonists

These agents may reduce sympathetic outflow, which may reduce muscle tone.


Midodrine is a prodrug with activity as an alpha1-adrenoreceptor agonist. This agent is widely used to treat orthostatic hypotension in MSA. Midodrine acts directly on the vasculature to increase BP and avoids electrolyte abnormalities associated with fludrocortisone. However, supine hypertension is a significant problem and limits the enhancement of functional capacity in MSA. Midodrine has often caused an unpleasant sensation in the scalp (due to piloerection).

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