Clonidine disorder

Umbricht A, Hoover DR, Tucker MJ, et al Opioid detoxification with buprenorphine, clonidine, or methadone in hospitalized heroin-dependent patients with HIV infection. Drug Alcohol Depend 69 263-272, 2003 Villagomez RE, Meyer TJ, Lin MM, et al Post-traumatic stress disorder among inner city methadone maintenance patients. Subst Abuse Treat 12 253—257, 1995 Mining E, Kosten TR, Kleber H Clinical utility of rapid clonidine-naltrexone detoxification for opioid abusers. Br J Addict 83 567-575, 1988 Washton AM, Pottash AC, Gold MS Naltrexone in addicted business executives and physicians. J Clin Psychiatry 45 39 1, 1984 Wesson DR Revival of medical maintenance in the treatment of heroin dependence (editorial). JAMA 259 3314-3315, 1988... 

Fyer AJ, Liebowitz MR, Gorman JM, et al Effects of clonidine on alprazolam discontinuation in panic patients a pilot study. J Clin Psychopharmacol 8 270—274,1988 Garvey MJ, Tollefson GD Prevalence of misuse of prescribed benzodiazepines in patients with primary anxiety disorder or major depression. Am J Psychiatry 143 1601-1603, 1986... 

Growth hormone. Mood disorders have been related to alterations in the activity of the growth-hormone axis. A blunted growth-hormone response to clonidine, an a2 receptor agonist, has been consistently found in depression. Increased growth-hormone secretion during the day and decreased nocturnal growth-hormone secretion have also been observed in depressed patients. Depressed patients have lower CSF concentrations of somatostatin, compared to those with schizophrenia and normal controls. While lower CSF somatostatin is a state-dependent marker of depression, it occurs in a number of unrelated nonpsychiatric conditions, and thus appears to be relatively nonspecific. 

Clonidine (Catapres). Like the beta blockers, clonidine acts by reducing norepinephrine activity, though by a different mechanism. Studies show that clonidine can provide early relief from the symptoms of a panic attack, but patients unfortunately relapse with continued treatment. Therefore, clonidine is not used in the treatment of panic disorder. 

Few studies have examined noradrenergic function in patients with phobic disorders. In patients with specific phobias, increases in subjective anxiety and increased heart rate, blood pressure, plasma NE, and epinephrine have been associated with exposure to the phobic stimulus (Nesse et al. 1985). This finding may be of interest from the standpoint of the model of conditioned fear, reviewed above, in which a potentiated release of NE occurs in response to a reexposure to the original stressful stimulus. Patients with social phobia have been found to have greater increases in plasma NE in comparison to healthy controls and patients with panic disorder (Stein et al. 1992). In contrast to panic disorder patients, the density of lymphocyte a-adrenoceptors is normal in social phobic patients (Stein et al. 1993). The growth hormone response to intravenous clonidine (a marker of central a2-receptor function) is blunted in social phobia patients (Tancer et al. 1990). 

Charney DS, Woods SW, Krystal JH, Nagy LM, Heninger GR (1992) Noradrenergicnenronal dysregnlation in panic disorder the effects of intravenous yohimbine and clonidine in panic disorder patients. Acta Psychiatr Scand 86 273-282 Coplan JD, Klein DF (1996) Pharmacologic probes in panic disorder. In Westenberg HGM, den Boer JA, Murphy DL (eds) Advances in the neurobiology of panic disorder. Wiley, New York, pp 179-204... 

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... 

Uhde TW, Tancer ME, Rubinow DR (1992) Evidence for hypothalamo-growth hormone dysfunction in panic disorder profile of growth hormone responses to clonidine, yohimbine, caffeine, glucose, GRF, and TRH in panic disorder patients vs. healthy volunteers. N europsychopharmacology 6 101-118... 

Effects of early environmental adversity on HPA mediation of neurodevelopment have also been demonstrated in non-human primates (Coplan et al., 1995). Corticotropin-releasing hormone (CRH) intracerebro-ventricular administration in rhesus monkeys that had been separated from their mothers produced behavioral inhibition and increases in ACTH and cortisol. Coplan et al (1995) presented evidence for persistently elevated cerebrospinal fluid concentrations of corticotropin-releasing factor (CRF) in grown macaques that had been reared by mothers in unpredictable environmental conditions. Further studies in adversely reared adult monkeys demonstrated an inverse relationship between mean CRF concentrations and GH response to clonidine (Coplan et al., 2000). In light of evidence that reduced GH response to clonidine has been shown in other anxiety disorders (Charney and Bremner, 1999), Coplan et al. (2000) hypothesize that GH response to clonidine may inversely reflect trait-like increases of central nervous system CRF activity. Data linking childhood anxiety to growth deficits are consistent with this view (Pine et al., 1996). Activity, of the HPA axis, as related to early environmental... 

Wilens, T, Biederman,]., and Spencer, T. (1994) Clonidine for sleep disturbances associated with attention deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 33 424 27. 

Broderick-Cantwell, J.J. (1999) Case study accidental clonidine patch overdose in attention-deficit/hyperactivity disorder patients. J Am Acad Child Adolesc Psychiatry 38 95-98. 

Connor, D.F., Barkley, R.A., and Davis, H.T (2000) A pilot study of methylphenidate, clonidine, or the combination in ADHD comorbid with aggressive oppositional defiant or conduct disorder. Clin Pediatr 39 15-25. 

Connor, D.E, Fletcher, K.E., and Swanson, J.M. (1999) A metaanalysis of clonidine for symptoms of attention-deficit hyperactivity disorder. / Am Acad Child Adolesc Psychiatry 38 1551-1559. 

Hunt, R.D., Minderaa, R.B., and Cohen, D.J. (1985) Clonidine benefits children with attention deficit disorder and hyperactivity re-port of a double-blind placebo-crossover therapeutic trial. / Am Acad Child Adolesc Psychiatry 24 617-629. 

Clonidine treatment of hyperactive and impulsive children with autistic disorder. / Clin Psychopharmacol 12 322-327. 

Scbvebla, T.J., Mandoki, M.W., and Sumner, G.S. (1994) Clonidine therapy for comorbid attention deficit hyperactivity disorder and conduct disorder preliminary findings in a children s inpatient unit. South Med J 87 692-695. 

Inattentiveness, impulsivity, hyperactivity 50% will continue to manifest the disorder into adulthood Stimulants (70% response for uncomplicated ADHD caution in patients with tic disorders) TCAs (70% response, first line for patients with comorbid MD or anxiety disorders, and for patients with ADHD + tics) requires serum levels and cardiovascular monitoring Bupropion Clonidine, guan-facine (first line for patients with ADHD + tics) MAOIs Combined pharmacotherapy for treatment-resistant cases... 

Steingard, R., Biederman, J., Spencer, X, Wilens, X, and Gonzalez, A. (1993) Comparison of clonidine response in the treatment of attention deficit hyperactivity disorder with and without comor-bid tic disorders. J Am Acad Child Adolesc Psychiatry 32 350-353. 

Uhde, T.W., Stein, M.B., Vittone, B.J., Siever, L.J., Boulenger, J.P., Klein, E., and Mellman, T.A. Behavioral and physiological effects of short-term and long-term administration of clonidine in panic disorder. Arch Gen Psychiatry 46 353. 

From the observation that tics were exacerbated by stress, and because cerebrospinal fluid flndings suggested possible alterations in central nervous system catecholamine metabolism, Cohen and colleagues (1979) used clonidine in the treatment of TS in what was among the first theory-based treatments for the disorder. 

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