An ACE inhibitor and thiazide combination is a drug combination used to treat hypertension (high blood pressure). They are given by mouth. ACE inhibitors reduce the activity of angiotensin-converting enzyme (ACE) which produces angiotensin II, a hormone that constricts blood vessels. Thiazides are a class of diuretics that inhibit the thiazide receptor, thereby increasing urine production and reducing excess water and salt in the body. Several organizations recommend combination therapy for hypertension in cases of failure of a single drug to achieve target blood pressure, or even as a first line treatment for some patients. Examples
Enalapril/hydrochlorothiazide (trade name Enalapril comp), wherein enalapril is the ACE inhibitor and hydrochlorothiazide is the thiazide. Quinapril/hydrochlorothiazide (trade name Accuretic)
Lisinopril/hydrochlorothiazide is marketed as Prinzide, Zestoretic, and many others. Fosinopril/hydrochlorothiazide
Fosinopril/hydrochlorothiazide (trade name Monopril HCT) has a boxed warning about its risk to cause morbidity and mortality in the baby when being used during pregnancy (2nd and 3rd trimesters).FDA  modified its labeling on February, 2009 to include a precaution of drug interaction with gold. "Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including Monopril/Monopril HCT." See also
Perindopril/indapamide, a combination of an ACE inhibitor and a thiazide-like diuretic


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Treatment
Anumonye reported treatment success with lorazepam; others found benefit with antidepressants and relaxation exercises. Epidemiology
BFS has been reported in other African cultures, and also in Brazil, Argentina, and Ethiopian Jews. Historic higher reported prevalence among males may be due to more males being present in higher education in African countries. Studies since the 1990s have not verified gender differences. Other studies found a possible association with low socioeconomic status, an association with average or higher intelligence, and a high association with neuroticism. Individuals with BFS have been found to have problems with isolation, poor study habits, and the use of psychostimulants as well as physical changes including in muscle tension and heart rate. History
The condition was first described by R. H. Prince who named the condition based on the term brain fag used by students who believed their symptoms were attributed to "brain fatigue". However, this term was used in the United States and Europe dating back to 1839. Furthermore, in a detailed historical account, Ayonrinde (2020) illustrates that contrary to widely held and published belief in diagnostic manuals, psychiatric, social science and educational text, the term "Brain Fag" and associated syndromes of anxiety, affective and somatoform symptoms in student and "brain worker" populations were first described in nineteenth century Britain (Tunstall, 1850) with dissemination across the British Empire. Ayonrinde concludes that, the time has come for the decolonization of brain fag and its African syndromization in the true spirit of ethical scientific rigor in the twenty-first century. See also
Burnout
Exhaustion


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