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Clonidine for the Treatment of Psychiatric Conditions and Symptoms: A Review of Clinical Effectiveness, Safety, and Guidelines

Last updated: February 21, 2018
Project Number: RC0961-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of clonidine for the treatment of adults with psychiatric conditions or symptoms?
  2. What are the harms associated with the potential misuse or abuse of clonidine?
  3. What are the evidence-based guidelines regarding the use of clonidine for the treatment of psychiatric conditions or symptoms in adults?

Key Message

Evidence from a retrospective chart review suggested that clonidine may be effective in treating combat nightmares in patients with post-traumatic stress disorder. A retrospective cohort study suggested that addition of clonidine to naltrexone therapy may reduce cigarette smoking and craving in an in-patient opioid detoxification setting. A randomized controlled trial demonstrated that a single dose of clonidine may adversely affect memory consolidation in patients with major depressive disorder and healthy volunteers. In a retrospective chart review, harms associated with clonidine overdose included impaired consciousness, miosis, hypothermia, bradycardia, hypotension, and severe hypertension and clonidine dose was negatively associated with minimum heart rate. No relevant evidence-based guidelines were identified. The small number of relevant studies identified (n = 4), the lack of large-scale studies (sample sizes of less than 120), and limitations in study design and quality prevented definitive conclusions from being drawn regarding the clinical effectiveness and safety of clonidine for the treatment of adults with psychiatric conditions or symptoms.