Nightmare clonidine

Horrigan, Clonidine 0.05 hs Single-subject n = 1 Clonidine improved nightmares for 4 None tepotted... 

Loof et al. (1995) reported the use of carbamazepine (300-1200 mg/day, serum levels 10-11.5 pg/mL) in 28 children and adolescents with sexual abuse histories. By treatment end, 22 of 28 patients were asymptomatic of PTSD. The remaining six were significantly improved in all PTSD symptoms except for continued abuse-related nightmares. Half of this cohort had com-orbid ADHD, depression, ODD or polysubstance abuse and were treated with concomitant medications, e.g., methylphenidate, clonidine, sertraline, fluoxetine, or imipramine. 

Clonidine, an antihypertensive drug, also has been used in the treatment of mania. Sudden withdrawal can produce a rebound hypertensive crisis. Consistent with the brain-disabling principles, it can produce a variety of psychiatric symptoms, including sedation, vivid dreams or nightmares, insomnia, restlessness, anxiety, and depression. More rarely, it can cause hallucinations. Unfortunately, this drug is too commonly used as a so-called mood stabilizer in children. When mistakenly prescribed with stimulants, it causes an elevated risk of cardiac arrhythmia and cardiac arrest in children. 

Methyidopa (Aldomet) As for clonidine. Also, synthesized to methyinorepinephrine which acts as a weak sympathomimetic "false neurotransmitter" which decreases sympathetic outflow from the CNS. As for clonidine. Used to treat hypertension in pregnant women. Dry mouth, sedation, slight orthostatic hypotension. Some patients experience impotence, psychic disturbances, nightmares, involuntary movements, or hepatotoxicity. 

An advantage of clonidine is the absence of orthostatic hypotension, but like a-methyldopa and reserpine it may cause drowsiness, and marked sedation occurs in up to 50% of patients treated in some series. Sedation can be so severe as to proceed to semi-consciousness. Nightmares and delusions are another expression of the drug s influence upon the central nervous system. Apart from sedation, the complaint of dry mouth and nose is the most common side effect recorded with clonidine administration. Dizziness, headache and fatigue are frequently mentioned, as well as anorexia, nausea, constipation and even pseudo-obstruction (94 ), anxiety, depression, drug fever and rashes. Side effects occur in 50—70% of the patients treated and are in some 20% the reason for discontinuation of therapy (3 , 13, 83 ). 

Clonidine may potentiate the effects of alcohol, sedatives and CNS depressants (102 ). High doses of clonidine combined with high doses of propranolol were in several cases associated with the development of nightmares, delusion and marked drowsiness (8 ). The combination of clonidine with the 3-adrenergic blocker Sotalol gave rise to an antagonistic effect, comprising a marked rise of blood pressure in 3 out of 6 cases so treated (103 ). 

---