ADHD Treatment: Is Clonidine Effective?

Written by Jeannette Belliveau | Published on January 22, 2014
Medically Reviewed by George Krucik, MD, MBA on January 22, 2014

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.

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 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
  • atomoxetine

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.

When you or your child reaches a stable maintenance dose, your doctor may prescribe a skin patch. The patch needs to be changed every three to five days for children, and every seven days for adults.

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