Anxiolytics clonidine

Alternative pharmacological approaches Clonidine, an o2 adrenergic agonist, has been employed as adjunctive therapy to assist in smoking cessation. However, results have been mixed or the effects small (Gourlay et al. 1994 Hilleman et al. 1993 Franks et al. 1989). Buspirone (BuSpar) is a 5-HTlA partial agonist with anxiolytic effects. It has been tested as a treatment for smoking cessation because anxiety is a prominent feature of nicotine withdrawal (Farid and Abate 1998). To date, results have been mixed and more controlled research is needed. 

Redmond DE Jr (1981) Clonidine and the primate locus coeruleus evidence suggesting anxiolytic and anti-withdrawal effects. Prog Clin Biol Res 71 147-163 Reiman EM, Raichle ME, Robins E, Butler FK, Herscovitch P, Fox P, Perlmutter P (1986) The applications of positron emission tomography to the study of panic disorder. Am J Psychiatry 143 469-477... 

Other possible uses, not addressed in this study, are the potential benefit of clonidine as an adjunct to lithium or anticonvulsants, possibly serving as a substitute for anxiolytics or antipsychotics, or its benefit in less severe exacerbations of mania. 

Other than slow taper, no consistently effective treatment to alleviate withdrawal symptoms has been reported. Although several compounds have been studied (e.g., b-blockers, clonidine, carbamazepine, abercamil, ondansetron), results have been contradictory ( 250). Carbamazepine, however, may be useful in seizure-prone patients (251). Valproate (VPA) has also been reported to benefit patients undergoing BZD discontinuation after long-term dependence ( 252), which may be related to VPA s potential anxiolytic properties, its ability to alleviate withdrawal phenomena, or both. The azaspirone anxiolytic buspirone has been reported ineffective in suppressing withdrawal symptoms, particularly in long-term BZD users (253, 254). Hydroxyzine has also been found beneficial in treating patients for lorazepam withdrawal (255). 

CENTRALLY ACTING ANTIHYPERTENSIVES ANXIOLYTICS AND HYPNOTICS Clonidine and moxonidine may exacerbate the sedative effects of BZDs, particularly during initiation of therapy Uncertain Warn patients of this effect and advise them to avoid driving or operating machinery if they suffer from sedation... 

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