Clonidine


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Clonidine (Catapres)

Clonidine (Catapres) is an antihypertensive drug (Manheim et al. 1982) that is effective in the treatment of ADHD (Hunt et al. 1985; Steingard et al. 1993). It has also been used to treat Tourette syndrome by reducing tics, improving hyperactivity, and decreasing obsessive-compulsive symptoms (Leckman et al. 1985; Leckman et al. 1991; Hewlett et al. 1992). Clonidine is an alpha-adrenergic stimulating agent that acts on presynaptic neurons to inhibit norepinephrine activity (fig. 8.2). Hunt et al. (1985) suggested that clonidine may be most beneficial in children with ADHD, who are easily emotionally overwhelmed, are anxious, and have a low frustration tolerance. Clonidine also stimulates growth hormone release (Leckman et al. 1984), and it causes sedation, so it may be helpful in treating the ADHD of children with FXS who have sleep disturbances, motor tics, or hyperarousal (chap. 1).

Leckman (1987) reported improved ADHD symptoms in three males with FXS treated with clonidine. Hagerman et al. (1995) reported a survey of 35 children with FXS who were treated with clonidine. Overall, 63% of the parents said clonidine was very beneficial for their child, 20% said clonidine helped their child a little, 6% said clonidine had no effect, and 11% said their child's behavior was worse on clonidine. Although 89% of the children were taking clonidine for hyperactivity, other problems, including aggression, tantrums, anxiety, and sleep disturbances, were common and were somewhat improved on clonidine. Most of the patients (69%) were also on other medications, including methylphenidate. For instance, in a young boy with FXS, clonidine was used successfully in the afternoon and evening, with methylphenidate in the morning and at lunchtime. Clonidine helped to alleviate the irritability in the late afternoon exacerbated by stimulants, the sleeping problems at bedtime, and the ADHD symptoms at home. Methylphenidate was better at school because a greater degree of concentration was demanded at school compared to home. The use of combined pharmacotherapy is an emerging trend in pediatric psychopharmacology because of the frequency of comorbid disorders and the benefit of a synergistic effect from two medications (Wilens et al. 1995, 1998, 1999).

Clonidine (Catapres): Continued

This article is not intended to give medical advice for individual cases. Any change in medical treatment should be done in consultation with appropriate medical personnel. This article is written for medical professionals. Some of the terms will be unfamiliar to those who are not trained in medical fields.

*This article is from the chapter on treatment in the 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research edited by Randi Jenssen Hagerman, M.D. and Paul Hagerman, M.D., Ph.D., to be published May 2002. It is included with permission from The Johns Hopkins University Press. References to other chapters refer to chapters in the book which are not included as part of this website.

The complete 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research can be ordered from the National Fragile X Foundation by calling 1-800-688-8765 or from The Johns Hopkins University Press at 1-800-537-5487.

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