The small number of relevant studies identified (n = 4), the lack of large-scale studies (sample sizes of less than 120), and limitations in study design and quality prevented definitive conclusions from being drawn regarding the clinical effectiveness and safety of clonidine for the treatment of adults with psychiatric conditions or symptoms.
No relevant evidence-based guidelines were identified. In a retrospective chart review, harms associated with clonidine overdose included impaired consciousness, miosis, hypothermia, bradycardia, hypotension, and severe hypertension and clonidine dose was negatively associated with minimum heart rate.
#SEVERE INSOMNIA FROM CLONIDINE TRIAL#
A randomized controlled trial demonstrated that a single dose of clonidine may adversely affect memory consolidation in patients with major depressive disorder and healthy volunteers. A retrospective cohort study suggested that addition of clonidine to naltrexone therapy may reduce cigarette smoking and craving in an in-patient opioid detoxification setting. It also reviews the harms associated with the potential misuse or abuse of clonidine.Įvidence from a retrospective chart review suggested that clonidine may be effective in treating combat nightmares in patients with post-traumatic stress disorder. This report aims to review the clinical effectiveness of and evidence-based guidelines for clonidine for the treatment of adults with psychiatric conditions or symptoms. Evidence regarding the use of clonidine for the treatment of adults with psychiatric conditions not restricted to PTSD or ADHD has yet to be summarized in a CADTH report. A 2013 CADTH report 13 summarizing evidence for the use of clonidine and three other drugs for the treatment of adults with ADHD found no systematic reviews or randomized controlled trials of clonidine in this population. Previous CADTH reports pertaining to the management of ADHD 11 and PTSD 12 have identified evidence-based guidelines that suggest clonidine can be used for the treatment of PTSD-associated nightmares and ADHD in adults. 8 - 10 Abuse of clonidine may be related to its above-mentioned effects 10 as well as its reported ability to potentiate and extend opioid-induced euphoria. 2, 6, 7 There have been case reports of patients abusing clonidine alone 8 or in combination with opioids or benzodiazepines. 5 Therefore, beyond its approved indications, clonidine has been used more recently to treat a variety of psychiatric conditions which include attention deficit hyperactive disorder (ADHD), post-traumatic stress disorder (PTSD), and Tourette syndrome. 4Īside from antihypertensive effects, clonidine can exert sedative, analgesic, and anxiolytic effects. 3 It is also indicated for the relief of menopausal flushing. 3 In Canada, oral clonidine is indicated for the treatment of hypertension in patients for whom diuretics and beta blockers are ineffective, are contraindicated, or cause adverse effects. 2 Clonidine is a fast-acting antihypertensive medication and its oral formulation typically requires twice daily dosing. 1, 2 This has the effect of lowering cardiac output and vascular resistance and clonidine is used to systemically lower blood pressure. Clonidine is an alpha-2 adrenergic receptor agonist which acts in the brain to decrease sympathetic outflow to the heart and peripheral vasculature.
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