[Clonidine for the treatment of heroin withdrawal syndrome]

In an open study of 50 patients with heroin addiction, clonidine was efficacious by mouth in the treatment of acute heroin-withdrawal syndrome. Mean administration of clonidine (on an "as-needed" basis) was 5 days (maximum 7 days), whilst the mean daily dosage ranged from 0.112 mg to 0.468 mg, the maximum requirement occurring on day 2 of withdrawal and sinking thereafter. Since insomnia was not influenced by clonidine, we offered 100 mg doxepine and/or 10 mg nitrazepam (the latter only until day 4 of treatment). Under this medication a sudden, dramatic decrease in blood pressure was not seen, mean blood pressure and pulse rate were not markedly altered; this may, perhaps, be a consequence of the blocking effect of doxepine on the peripheral hypotensive actions of clonidine. Of the 9 drop-outs from treatment, five (10% of the total 50) were certainly directly attributable to the lack of response to clonidine, representing a failure of therapy in 10% cases at least.