Clonidine for Central Autonomic Instability

Mechanism of Action and Clinical Applications

Clonidine reduces central sympathetic outflow and alleviates symptoms of autonomic overactivity such as tachycardia, hypertension, diaphoresis, restlessness, and diarrhea, by stimulating α2-adrenoreceptors in the brain stem, resulting in decreases in peripheral resistance, renal vascular resistance, heart rate, and blood pressure 1, 2
Clonidine is particularly useful in managing symptoms of autonomic overactivity including tachycardia, hypertension, diaphoresis, and restlessness, by reducing CNS sympathetic outflow 1, 2

For adults, typical oral dosing ranges from 0.1-0.8 mg daily, usually divided into two doses, and is available in both oral tablet form and transdermal patch 3

Clonidine must be tapered gradually to avoid rebound hypertension, as abrupt discontinuation can induce hypertensive crisis 3
Cessation of clonidine treatment can result in a rebound of autonomic activity, which can be particularly dangerous in patients with autonomic instability 1, 2
Use with caution during pregnancy and breastfeeding as clonidine crosses the placental barrier and is found in human milk 3