Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder
1Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, Nevada, USA.
Drugs of Today (Barcelona, Spain : 1998)
|March 31, 2012
Summary
Extended-release clonidine, an alpha-2 adrenoceptor agonist, effectively treats attention-deficit/hyperactivity disorder (ADHD) when stimulants are insufficient. It offers improved efficacy and tolerability as adjunctive therapy.
Area of Science:
- Neuroscience
- Pharmacology
- Child and Adolescent Psychiatry
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder.
- Psychostimulants are first-line ADHD treatments, but up to 30% of patients show inadequate response.
- Alpha-2 adrenoceptor agonists can enhance ADHD symptom control in non-responders.
Purpose of the Study:
- To review the use of clonidine, an alpha-2 adrenoceptor agonist, as an adjunct to stimulant therapy for ADHD.
- To compare immediate-release (CLON-IR) and extended-release (CLON-XR) clonidine formulations.
- To evaluate the safety and efficacy of extended-release alpha-2 adrenoceptor agonists in ADHD management.
Main Methods:
- Review of recent double-blind, placebo-controlled trials.
- Analysis of pharmacokinetic properties influencing efficacy and tolerability.
- Focus on clonidine's synergistic effects with stimulants.
Main Results:
- Extended-release alpha-2 adrenoceptor agonists demonstrate safety and effectiveness.
- These agents improve ADHD symptoms as monotherapy and adjunctively with stimulants.
- CLON-XR may offer advantages over CLON-IR due to pharmacokinetic differences.
Conclusions:
- Extended-release alpha-2 adrenoceptor agonists, particularly clonidine, are valuable options for optimizing ADHD treatment.
- Adjunctive therapy with clonidine can improve outcomes for patients with inadequate stimulant response.
- Further research into formulation-specific effects is warranted.
More Related Videos
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
01:28Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
01:24CNS Stimulants: Cocaine, Amphetamines and Cannabinoids
CNS stimulants, such as cocaine, amphetamines, and cannabinoids, have varying structures and mechanisms of action that lead to different therapeutic effects and side effects. Cocaine, with its molecular formula C17H21NO4, is a tropane alkaloid and a tertiary amino compound. It has two chemical forms: the hydrochloride salt and the "freebase." The former is in powder form, while the latter involves removing the hydrochloride salt to create a form that can be smoked. Cocaine exerts its effects by...
01:30Adrenergic Agonists: Therapeutic Uses
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
01:26Cholinergic Antagonists: Therapeutic Uses
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal secretions in common...
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal secretions in common...
01:23Antidepressant Drugs: MAOIs and Other Agents
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...