ADHD (Attention Deficit Hyperactivity Disorder)
ADHD Treatment: Is Clonidine Effective?
Looking for Answers for ADHD
Clonidine isn’t the go-to drug for attention deficit hyperactivity disorder (ADHD). That honor belongs to stimulants such as methylphenidate (Ritalin).
However, stimulants may not be appropriate for ADHD patients with sleep disorders, tics, or Tourette’s syndrome. Clonidine may be a better option for these patients.
Click through the slideshow to learn more about the effectiveness of clonidine for treatment of ADHD.
Clonidine’s Drug Family
Clonidine is used mainly to treat high blood pressure. It comes from a group of medications called alpha-agonist hypotensive agents. These agents relax blood vessels.
Their exact mechanism in helping ADHD patients is uncertain. It’s believed that clonidine may correct the activity of certain brain receptors. This may help reduce hyperactivity and impulsivity.
Who Clonidine May Work For
Doctors call clonidine a third-line agent for ADHD. That is, it’s considered not as effective as stimulants and antidepressants. But, it can work for patients who don’t respond to or can’t tolerate stimulants or antidepressants.
Clonidine also may allow the patient to avoid side effects that occur with stimulants, such as irritability and anorexia. If your child has the inattentive form of ADHD, clonidine may not be the best choice.
Seeking an Effectiveness Verdict
Neuroscientists at the New Jersey Medical School examined Medline’s database of clinical trials registered from 1996 to 2011. They looked for information regarding the effectiveness and safety of clonidine for children with ADHD.
They uncovered 10 clinical trials in that period. Eight were double-blind and placebo-controlled. The researchers concluded that clonidine could be effective in selected patients. They also unearthed additional details discussed on the next slide.
Side Effects and Types
The New Jersey Medical School researchers noted the following:
- In certain patients, clonidine and clonidine extended release can work well on their own and combined with stimulants.
- Patients tolerated clonidine and clonidine extended release well.
- The studies did not make it clear whether the extended release version worked better than regular clonidine.
- Patients experienced side effects including fatigue, headache, low blood pressure, and slow heart rate.
- Anecdotal reports describe serious cardiac incidents, including death, for patients with other risk factors.
For Patients with Partial Responses to Stimulants
Researchers took a close look at clonidine in a 2011 study. The study examined how well the drug works in combination with methylphenidate for children and adolescents who show a partial response to stimulants.
Researchers gave 102 patients clonidine along with their current stimulant. Another 97 patients took a placebo along with their current stimulant. Clonidine recipients showed greater improvement on rating scales for ADHD than placebo recipients.
For Patients with Tourette’s
A 2013 study supported the view that clonidine can help patients with tics and Tourette’s syndrome.
The researchers looked at studies published from 1990 to 2012. These studies listed three classes of drugs for patients with Tourette’s and ADHD:
- alpha-agonists, such as clonidine and guanfacine
- stimulants, such as methylphenidate and amphetamines
The evidence supported clonidine as a first-line treatment for patients with both disorders.
More About Dosage
If stimulants or antidepressants are not proving to be effective for treating ADHD, you may want to talk to your doctor about clonidine.
Clonidine is available as a tablet or a patch. Treatment starts with a low dose taken at bedtime. The drug should improve ADHD symptoms in two to three weeks.
- Barrett, J.R. et al. (2013, December). To Sleep or Not To Sleep: A Systematic Review of the Literature of Pharmacological Treatments of Insomnia in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Journal of Child and Adolescent Psychopharmacology, 23(10), 640-647. Retrieved December 9, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/24261659
- Catapres (clonidine hydrochloride) tablets. (2012, May). U.S. Food and Drug Administration. Retrieved December 9, 2013, from http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm194113.htm
- Catapres-TTS (clonidine) trandsdermal therapeutic system. (2012, June 12). U.S. Food and Drug Administration. Retrieved December 9, 2013, from http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm194114.htm
- Clonidine. (2010, October 1). National Institutes of Health. Retrieved December 9, 2013, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682243.html
- Helms, R.A. (2006). Textbook of therapeutics: drug and disease management [Google Books version]. (8th ed.). Retrieved December 9, 2013, from http://books.google.com/books?id=aVmRWrknaWgC&pg=PA1480&dq=effectiveness+clonidine+adhd&hl=en&sa=X&ei=y2SlUpaLIcW4kQf0koCYAQ&ved=0CEkQ6AEwAg#v=onepage&q=effectiveness%20clonidine%20adhd&f=false
- Kollins, S.H., Jain, R., Brams, M., Segal, S., Findling, R.L., Wigal, S.B. et al. (2011). Clonidine Extended-Release Tablets As Add-on Therapy To Psychostimulants In Children And Adolescents With ADHD. Pediatrics, 127(6), e1406-e1413. Retrieved December 9, 2013, from http://pediatrics.aappublications.org/content/127/6/e1406.abstract
- Ming, X. (2011). Safety and efficacy of clonidine and clonidine extended-release in the treatment of children and adolescents with attention deficit and hyperactivity disorders. Adolescent Health, Medicine and Therapeutics, 2011, 105-112. Retrieved December 9, 2013 from http://www.dovepress.com/safety-and-efficacy-of-clonidine-and-clonidine-extended-release-in-the-a8392
- Rizzo, R. (2013). Tourette Syndrome and comorbid ADHD: current pharmacological treatment options. European Journal of Paediatric Neurology, 17(5), 421-428. Retrieved December 9, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/23473832