Clonidine Hydrochloride (Clonidine) is an anti-hypertensive drug that works by stimulating alpha-adrenoceptor 2 receptors and which has also been used to control tics in children with conditions such as Tourette’s syndrome and to treat patients with ADHD.
Clonidine works on a pathway different to dopamine and along with guanfacine is now considered a first choice anti-tic medication for children with Tourette’s syndrome with an acceptable side effect profile. This article will focus on the use of clonidine in tic disorders such as Tourette’s syndrome and PANDAS.
Typical starting doses are 25-50 micrograms once daily escalating on a weekly basis to 300-400 micrograms per day (total daily dose) which is divided into 2-3 doses. Note that this is different to the BNF dosing regime for hypertension. It is recommended that blood pressure is monitored throughout the period when doses are altered.
Side effects include constipation, dizziness, drowsiness, dry mouth, headache, malaise and interactions with other drugs with cardiovascular effects. The full range of side effects and drug interactions can be seen by clicking on the summary of product characteristics.
Stopping clonidine must be done slowly (over 2 weeks minimum) and in a controlled manner because of the effects on blood pressure. If you do stop clonidine suddenly you may risk your child’s blood pressure becoming dangerously high.