Antihypertensives for attention deficit hyperactivity disorder

Examples

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Brand Name	Chemical Name
Catapres	clonidine hydrochloride

Brand Name	Chemical Name
Tenex	guanfacine hydrochloride

These medications are usually used to reduce high blood pressure, but they are often combined with stimulants for the treatment of attention deficit hyperactivity disorder.

How It Works

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It is not known exactly how these medications work when used to treat attention deficit hyperactivity disorder (ADHD). They appear to affect the body's production of norepinephrine, a brain chemical that helps control moods.

Why It Is Used

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These medications are useful in treating children who have ADHD, especially those who have repetitive muscle movements (tics) or significant problems controlling their impulses and aggression.

• A combination of clonidine and methylphenidate (a stimulant, such as Concerta or Ritalin) has helped some children with difficult behavioral problems.
• Guanfacine may improve attention, impulse control, and irritability.

How Well It Works

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Research has shown that when clonidine is used with a stimulant medication, it reduces aggressive and disruptive behavior. ¹

These antihypertensives seem to improve symptoms in some people with ADHD, especially those with symptoms of frustration, extreme hyperactivity, and aggressiveness. They are also used for children with ADHD and tic disorders.²

Guanfacine seems to be as effective as (or more effective than) clonidine in treating ADHD and causes less drowsiness.

People with ADHD may show a greater improvement in symptoms when guanfacine is given in combination with psychostimulants.

Side Effects

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The most common side effects of clonidine and guanfacine are drowsiness and dizziness. However, these symptoms seem to go away after a few weeks of treatment. No serious side effects have been associated with these medications, and any changes in blood pressure are minimal. Small studies show that clonidine and guanfacine are safe.²

Very rare side effects of clonidine include depression and irregular heartbeat.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Clonidine is not given to people who have heart or blood vessel diseases.

Tips for taking clonidine

• Don't stop taking the medication without talking with your doctor because your blood pressure might rise too quickly.
• Take the medication daily, as prescribed.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Hazell LH, Stuart JE (2003). A randomized controlled trial of clonidine added to psychostimulant medication for hyperactive and aggressive children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(8): 886–894.

2. Scahill L, et al. (2001). A placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. American Journal of Psychiatry, 158(7): 1067–1074.

Credits

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Author	Sabra L. Katz-Wise
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman
Associate Editor	Terrina Vail
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Mina Dulcan, MD - Child and Adolescent Psychiatry
Last Updated	May 31, 2006