University of Virginia Health System

CLONIDINE

• Advantages/Disadvantages:
  • May suppress tics
  • May be preferred agent to treat aggressive or hyperaroused behaviors
    • More effective in controlling aggressive/hyperaroused symptoms than other agents
    • Improves inattentive symptoms to a lesser extent than other agents
  • Somnolence may limit use but often resolves with time
  • Rebound HTN if stopped rapidly
  • May be contraindicated for patients with cardiac pathologies
• Availability:
  • 0.1, 0.2, 0.3 mg
  • Transdermal Patch 0.1, 0.2, 0.3 mg/day (Lasts 7 days)
• Starting Dose:
  • 0.025-0.05 mg qhs
• Onset of Action:
  • 1-2 weeks for maximal effect
• Duration of Action:
  • N/A
• Dosage Adjustment:
  • Increase to BID after 5-7 days, then to TID after another 5-7 days. Then increase by 0.025-0.05 mg/day every 5-7 days till therapeutic effect achieved. (Titrate up very slowly to minimize somnolence --- one of the most common reasons parents dislike/discontinue this medication.)
  • Monitor blood pressure and heart rate with each increase in dose
  • To discontinue, wean over one week (9).