Posts Tagged ‘clonidine for opioid withdrawal’

Why We Use Clonidine for Opioid Withdrawal

A little doctor humor

A little doctor humor

 

Clonidine has been used for decades as a blood pressure medication. It’s cheap and effective, but has some unpleasant side effects: sedation, dry mouth, and constipation. Because newer blood pressure medications have fewer side effects, clonidine is used less today than in the past to treat high blood pressure.

However, it is at least moderately effective at treating many of the symptoms of opioid withdrawal.

Among many other places in the central nervous system, opioids act on a part of the brain called the locus ceruleus. The locus ceruleus, which in Latin means the “blue place,” is part of the system that controls the autonomic nervous system. When locus ceruleus neurons are stimulated, norepinephrine is released into the brain, and this causes overall stimulation of the brain.

Opioids slow the firing of these neurons in the locus ceruleus, reducing the release of norepinephrine. When the body gets opioids regularly from an outside source, the locus ceruleus makes adjustments to make up for extra opioids. Then if the supply of opioids is suddenly stopped, the locus ceruleus becomes unbalanced, and releases an overabundance of norepinephrine. The heart rate and blood pressure increase, along with other symptoms: runny nose, yawning, tearing of the eyes, diarrhea, and nausea.

Since clonidine works by calming the locus ceruleus, clonidine reduces many of these unpleasant opioid withdrawal symptoms.

So how effective is clonidine? Most patients say that it helps somewhat, but they still feel withdrawal symptoms. My impression from what patients have described is that clonidine is mildly to moderately effective.

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