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Clonidine for ADHD

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Clonidine for ADHD

Trade names of clonidine are:

  • Catapresan (A, D, CH)
  • Haemiton (D)
  • Isoglaucon (A, D)
  • Paracefan (D)

Clonidine is an alpha 2-adrenoceptor agonist.

  • Agonist of the σ-2A-adrenoreceptor1
  • Agonist of the σ-2B-adrenoreceptor1
  • Agonist of the σ-2C-adrenoreceptor1

If the dosage is too high too quickly (injected), clonidine may also act as a σ-1-adrenoreceptor agonist.2

Clonidine is a rather atypical medication for AD(HHD).
Clonidine is commonly used in autism spectrum disorders and may be helpful in comorbid ASD + ADHD in young children.3

Clonidine attenuates the effect of epinephrine.

Clonidine has higher side effects than methylphenidate and atomoxetine.1

Alpha-2 adrenoreceptors are activated by the neurotransmitters adrenaline and noradrenaline. They are thus responsible for the effects mediated by adrenaline and noradrenaline.4
Alpha 2-A receptor agonists such as clonidine and guanfacine are thought to enhance phasic norepinephrine release in the nucleus coeruleus, which improves attention as well as working memory and visuomotor-associated learning (in contrast to long-term tonic NE release, which worsens performance).5

Clonidine thus has a noradrenergic effect.

As an alpha-2-adrenoceptor agonist, clonidine (like guanfacine ) significantly reduces dopamine release in the nucleus accumbens in the laboratory.6

A combination of clonidine and guanfacine is said to be helpful for Rejection Sensitivity (and/or Dysphoria?) in ADHD according to the field report of an American ADHD specialist.7

A 2019 study from India reported that clonidine was the most commonly used medication for ADHD there in a group of children 3 to 6 years old with ADHD:8

  • Clonidine: 44, 6 %
  • Risperidone: 28.7
  • Methylphenidate: 10.7 %
  • Atomoxetine: 10.7

2. Side effects

Side effects of clonidine have not yet been incorporated.

Individual Note: Endothelial damage (damage to the inner layer of blood vessels) may be more common in older individuals. In these, clonidine could increase the risk of vascular damage and thrombosis.9