From the Guidelines
Clonidine is effective in reducing anxiety symptoms, particularly in patients with post-traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD) 1.
Mechanism of Action
The medication works by suppressing the sympathetic nervous system outflow throughout the brain, which leads to a decrease in the release of norepinephrine, a neurotransmitter involved in the body's stress response 1.
Dosage and Administration
The typical dosage for anxiety management ranges from 0.1 to 0.3 milligrams per day, administered orally in divided doses, with treatment durations varying from 8 to 12 weeks 1.
Benefits
Clonidine has been shown to be beneficial in reducing the frequency of nightmares in patients with PTSD, with some studies reporting a significant decrease in nightmare frequency and improved sleep quality 1.
- The medication has also been found to be effective in reducing anxiety symptoms in patients with ADHD, particularly when used in conjunction with other medications 1.
- Clonidine's ability to decrease the release of norepinephrine makes it a useful treatment option for anxiety symptoms, as it helps to alleviate the body's stress response 1.
Important Considerations
It is essential to note that clonidine can cause somnolence and fatigue as adverse effects, and administration in the evening is generally preferable to minimize these effects 1.
- Additionally, clonidine has been approved as adjunctive therapy to stimulant medications, which can help increase treatment effects and decrease adverse effects of stimulants, such as sleep disturbances and cardiovascular effects 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Clonidine stimulates alpha-adrenoreceptors in the brain stem. The FDA drug label does not answer the question.
From the Research
Mechanism of Action
- Clonidine is an alpha-2 agonist that decreases sympathetic outflow from the central nervous system, which can help reduce anxiety symptoms 2, 3.
- The medication acts on the anterior and posterior hypothalamus, as well as the medulla, to inhibit excitatory cardiovascular neurons and decrease norepinephrine release, leading to diminished sympathetic outflow from the CNS 3.
Therapeutic Effects
- Clonidine has been shown to have short-term anxiolytic effects in patients with panic disorder, although these effects may not persist with long-term administration 4.
- The medication may be useful in treating symptoms of agitation and hyperarousal in patients with post-traumatic stress disorder (PTSD), particularly when selective serotonin reuptake inhibitors (SSRIs) are not effective 2, 5.
- Clonidine has also been used to treat obsessive-compulsive disorder (OCD), with some case reports showing significant improvement in symptoms 6.
Clinical Applications
- Clonidine may be considered as an adjunctive treatment for anxiety disorders, including PTSD and OCD, particularly in cases where first-line treatments are not effective 6, 2, 5.
- The medication has been shown to improve sleep quality and reduce nightmares in patients with PTSD, although more research is needed to confirm its efficacy in this area 5.