Clonidine is an FDA-approved drug primarily used to treat hypertension. Yet, apart from hypertension, many doctors prescribe clonidine for conditions including anxiety disorders, ADHD, migraine, insomnia & menopausal flushing as an off-label drug.
Why should be an anti-hypertensive drug prescribed to patients with anxiety disorders? If recommended as such, how effective is it in treating anxiety? are these questions puzzling you? If yes, keep reading the post and find the relevance.
What is Clonidine?
Clonidine comes under the drug classification imidazoline, and it acts by stimulating the alpha-2 adrenoreceptors in the brain stem, which results in decreased heart rate and blood pressure.
Clonidine is commonly available in the brand name Catapres (or) Kapvay in the market on various formulations such as oral tablets, transdermal patches & injections. It is also available in a topical gel form for patients suffering from diabetic neuropathy to relieve pain.
Clonidine was first formulated to treat hot flashes in 1970.
Off-Label uses of Clonidine.
Beyond its approved indication, clonidine has been used more recently to treat various other conditions, includes
Clonidine for anxiety and other psychiatric conditions
Anxiety disorders are the most common psychiatric disorders worldwide. Anxiety can lead to work and school absences and cause a higher cost burden than other mental disorders. There are various types of anxiety disorders which includes
- Generalized anxiety disorder
- Social anxiety disorder
- Panic disorder
- Phobia-related disorders.
‘Phobia’, The name came from, The Greek god Phobos, who frightened his enemies
Unfortunately, anxiety disorders are underdiagnosed and untreated.
Formally clonidine is only prescribed to high blood pressure patients. But, in recent times, many psychiatrists and physicians are prescribing clonidine for anxiety, and it seems way more effective than other anxiolytics in treating patients with both hypertension and anxiety disorders, says Dr. Sudha Reji, Psychiatrist.
Studies show that clonidine’s effects on anxiety are excellent compared to placebo (no drug). The pill clonidine mainly decreases anxiety attacks and psychic symptoms. Clonidine also reduces opiate-related withdrawal anxiety.
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Association between anxiety and hypertension
Anxiety and hypertension are having an interlink.
According to some meta-analyses, anxiety is one of the main hurdles in treating patients with hypertension. Hence anxiety and hypertension management together are essential.
Besides, Anti-anxiety medications such as SNRI (Serotonin-Norepinephrine Reuptake Inhibitors) could increase blood pressure in people.
A person with anxiety has a higher risk of developing hypertension than an average person and vice versa. In such a condition, the patient needs a drug to solve both problems. Hence, psychiatrists prescribe clonidine in anxiety disorders.
There are direct and indirect links showing anxiety can increase blood pressure.
Taphephobia is fear of being buried alive
Direct link
- Anxiety can increase blood pressure by activation of the sympathetic nervous system.
- Stress increases low-density lipids (bad cholesterol) and decreases high-density lipids (good cholesterol).
- Anxiety cause dysfunction of the HPA axis (hypothalamic pituitary adrenal axis), which can increase BP.
Indirect link
Due to anxiety and stress, people become vulnerable to unhealthy lifestyles such as excessive alcohol intake, smoking, overeating, and less physical activity, impacting the quality of life and literally increase one’s blood pressure.
Clonidine- The right drug for anxiety and insomnia
Clonidine acts by affecting the Norepinephrine activity in the brain. Norepinephrine is responsible for controlling blood pressure, heart rate and anxiety in the body. Hence, clonidine makes the brain “Less Excited” which helps improve the symptoms of anxiety. Clonidine, indeed, is an effective drug for treating anxiety disorders and associated psychiatric conditions.
Moreover, clonidine is an excellent drug of choice targeting insomnia in ADHD and remains a good remedy for paediatric insomnia overall. In addition, a study reported that clonidine seems beneficial and reasonably well-tolerated in stubborn sleep disorders in children and young adults with neurodevelopmental disorders.
Clonidine dosage for anxiety and drug formulations
Clonidine oral tablets
Your psychiatrist will decide the daily dosage of clonidine as per your requirement.
Clonidine oral tablets are available in the following strengths in the market 0.1 mg, 0.2 mg & 0.3 mg.
You can differentiate the dosage strength of Catapres by its color coding
0.1 mg – tan
0.2 mg- orange
0.3 mg- peach
Recommended first day of dose of clonidine is half of 0.1mg.
Pharmacophobia is a fear of medicines
Clonidine transdermal patches
If oral clonidine is effective, then why transdermal patches? Good question!
Patients who take multiple medicines in a day can opt for clonidine transdermal patches, and our body will quickly absorb the active medication through the patches than the oral route.
These transdermal patches are available in the following strengths in the market 2.5, 5.0, 7.5 mg.
If we need the drug’s best absorption, place the patch on the chest or upper arm.
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Side effects of Clonidine
The common side effects reported by many patients are
- Dry mouth
- Drowsiness
- Dose-related sedation
- Constipation
Suddenly stopping the drug intake may lead to severe withdrawal effects. So, consult your physician before quitting the medicine.
Clonidine Drug Review
According to drugs.com, patients who have used clonidine for anxiety have shown significantly positive results, especially people suffering from hypertension & anxiety.
Clonidine misuse or abuse
Accidental or intentional intake of clonidine produces hypotension (low bp), bradycardia (decrease heart rate), hypertension (high bp), arrhythmia (irregular heart rate), and death.
Clonidine toxicity can be treated by naloxone or atropine.
Ergasiophobia is a fear of Writing
Clonidine addiction
Clonidine is a relatively safe drug, but patients may sometimes get addicted to these drugs due to its sedative effect.
Self-medication leads to a physical and psychological dependency on clonidine.
How to find out the patient has clonidine dependency
- The patient feels the drug clonidine is needed regularly.
- A person spending more money on clonidine than he/she can afford
- Feel to take clonidine as an intense urge
Clonidine for anxiety pros & cons
Conclusion
Most of the patients say clonidine as a miracle drug for anxiety. Anyway, drug selection is in the hand of the psychiatrist. He will outweigh the risk and benefit of your health and pick the right drug.
1.Clonidine
https://www.ncbi.nlm.nih.gov/books/
2.Clonidine Use in Psychiatry: Panacea or Panache?
https://pubmed.ncbi.nlm.nih.gov/27161101/
3.Pharmacotherapy of Anxiety Disorders: Current and Emerging
Treatment Options
https://pubmed.ncbi.nlm.nih.gov/33424664/
4.Clonidine for the Treatment of Psychiatric Conditions and Symptoms: A Review of
Clinical Effectiveness, Safety, and Guidelines
https://pubmed.ncbi.nlm.nih.gov/30303668/
5.Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies
https://www.ncbi.nlm.nih.gov/pmc/
6. Clonidine drug label
