Effect of Terazosin on ATP Levels in People With Amyotrophic Lateral Sclerosis

Prior treatment

• Known allergy or previous adverse reaction to terazosin or related compound
• Current use of terazosin or concurrent use of doxazosin, alfuzosin, prazosin, or tamsulosin at the time of screening visit or within the 3 months prior to baseline visit
• Taking therapeutic anticoagulant medication (i.e. warfarin, DOAC's, full dose Lovenox or heparin)
• Noncompliant or sporadic use of medications that modulate the central nervous system
• Noncompliant or sporadic use of antihypertensive medications
• Currently taking part in another clinical trial with an investigational medicinal product or having taken part in one in the three months prior to screening visit

Other illness

• Traumatic brain injury or post-traumatic stress disorder
• Presence of a confounding acute or unstable medical, psychiatric, or orthopedic condition
• Uncontrolled major depression or bipolar affective disorder, or other mental health disorders that are, in the opinion of the PI, sufficiently severe to increase risk of experiencing an Adverse Drug Reaction (ADR)
• Current diagnosis of diabetes (type 1 or type 2) or healthcare professional-recommended treatment (medication, exercise or diet) of diabetes mellitus

Lab values

• Liver function blood tests (ALT or AST) more than twice the upper limit of normal
• Hemoglobin \< 11.0 g/dL
• Screening visit glucose \>140 mg/dl

Other

• Orthostatic hypotension at screening is defined as decrease in BP \> 20 mmHg systolic or \> 10 mmHg diastolic and HR increase \<20 bpm on transition from supine to sitting or from sitting to standing
• Pregnancy or breastfeeding women
• Current suicidal ideation as measured by question 2 of the Columbia-Suicide Severity Rating Scale (C-SSRS)
• Participants with insufficient decisional capacity to provide written informed consent determined by the primary investigator.
• Unable to lie supine and still for 60 minutes for the duration of the study

• Ages 18 - 80 years old
• Diagnosed with ALS based on Gold Coast Criteria
• ALS symptom onset within 36 months at enrollment
• Slow vital capacity (SVC) greater than or equal to 60%
• Riluzole use-Never taken or taking a stable dose for at least 4 weeks prior to screening visit or will refrain from starting for the duration of the study
• Edaravone use-Never taken or completed at least one cycle (typically 14 days) prior to screening visit or will refrain from starting for the duration of the study
• Must have the ability to swallow pills at the time of the screening visit, and in the principle investigator's opinion, have the ability to swallow pills for the duration of the study
• Willing to use highly effective contraception for the duration of the trial treatment and for a duration of 80 days after the last dose.