View Full Version : How does clonidine help ADHD?


Geno
07-24-12, 10:57 PM
I thought part of ADHD was a deficiency in Norepinephrine(dopamine too), and clonidine is an a2 agonist which LOWERS norepinephrine in the brain.

Stratters on the other hand INCREASES NE levels.

Geno
07-25-12, 12:28 AM
I can't edit posts, so I'll add this here: I'm not talking about clonidine in addition to a stimulant, but clonidine by itself is also sometimes used for ADHD.

hollywood
07-25-12, 11:41 AM
I don't think clonidine really works like that . It enhances the firing or binding of NE in the feedback loop in the pre frontal cortex. I am not totally certain on how exactly it works but it is supposed to enhance working memory. Some studies support this while other studies report no changes in adult males and that sedation was a problem. I have found that it does help calm the mind by eliminating distractions and thus enhances attention to a target stimulus. Anyways, adhd really does suck.

bobC
08-29-12, 02:20 PM
Your correct that alpha-2 stimulation reduces NE levels which leads to lower alpha-2 stimulation from NE. While this could make dosing more difficult it seems like alpha-2 medications are useful in treating adhd.

It has been established that ADHD responds best to a mix of Dopamine + NE stimulation. vs only dopamine stimulation or only NE stimulation.

So its more of a question of how much adhd symptom improvement from the NE side comes from NE overall vs NE stimulation of alpha-2 receptors.

I wonder if a med combo which hits dopamine + alpha 2 receptors would work as well as stims + have less side effects from increasing NE levels.

Bobc

hollywood
09-01-12, 12:12 AM
I theorize that focalin or ritalin plus wellbutrin with an alpha agonist would work

InvitroCanibal
06-18-13, 01:18 AM
Clonidine... in theory, acts as an alpha agonist that works through feed back inhibition and regulates sympathetic outflow. (Read this to understand the role of the sympathetic nervous system in general http://www.sciencedaily.com/articles/s/sympathetic_nervous_system.htm(

It essentially inhibits the fight or flight response from taking control on the pfc regions and there by preventing a cause of impulsivity or hyperactivity. It allows you to have more control over you basically.

Hyperactivity in adults looks like stress, anxiety, worry etc. The main issue with adhd is that our fight or flight responses are always primed. That's what the general research shows anyways. Hyperactivity is a complex thing really, in that it can look like anxiety, express itself as anxiety but not actually be anxiety. For example, general anxiety is too much dopamine in the brain which competitively inhibits a lot of the serotonin in ones brain. These are your GAD and OCD disorders that can look very similar to adhd sometimes. The difference is that ADHD is caused (in theory) by a lack of DAT transporter and several other chemical messengers. So you wouldn't approach ADHD treatment by lowering dopamine rather, you'd essentially target the source of anxiety (the sympathetic systems) and block it's affect on the rest of the cns and pfc systems so that one could take a stimulant without getting fight or flight reactions all the time or just be calm without stimulant medication in general, if they are primarily hyperactive.

That's just my general understanding, I apologize if i'm wrong and by all means take what I say with a grain of salt. Feel free to correct me if im wrong

SquarePeg
06-18-13, 02:48 AM
This is copied from a course I recently took.


Its a partial agonist of Norepinephrine, it decreases tonic and phasic activity of the locus ceruleus making it a little less erratic. There's also evidence that it increase the efficiency of neurotransmission in the prefrontal cortex. This med helps people who are highly aroused, impulsive, emotionally charged up, irritable, explosive. They also help to reduce anxiety, defiance and agression and they're useful for controlling tics.

They work primarily at the norepinephrine neuron. Clonidine works at Alpha 2A, 2B and 2C receptors, What happens is that the medications stimulate the Alpha 2A receptors, which increases cyclic AMP production, which closes the nearby HCN channels, and increases then, the dendritic cell excitability. And it strengthens the connectivity of the microcircuits of the dorsal lateral prefrontal cortex. So in working memory and distractibility in monkeys and in humans, is improved. Distractibility is reduced. And the profusion during working memory tasks in these areas is enhanced in monkeys, when you give them either Guanfacine or Clonidine.

The right amount of norepinephrine stimulation then causes the Alpha 2A receptors to inhibit cyclic AMP and therefore the neurons communicate more effectively. In this slide here, you can see this is a taken from a cross section of the den, the prefrontal cortex, dendritic spines. Under optimal neurotransmission Guanfacine or norepinephrine work at reducing cyclic AMP, and therefore the, the there's less of a, of a decline in the, in the signal. Whereas without alpha 2A stimulation, cyclic AMP allows the signal to be diverted away. And that's suboptimal transmission.

So, when there's inadequate stimulation then the, the ion channels are, are open, and that weakens the neuronal input and so this is where the indirect effect, if you will, of the adrenergic receptors plays a role in, in neurotransmission in the prefrontal cortex. Presumably, then, that will increase both concentration and task completion and efficiency

. Side effects, though, of the Alpha 2A Adrenergic agonists are important to consider. There's sedation and fatigue, and dizziness and these could be rate limiting problems. If you have to dose these medications very gradually in order to avoid the problems of sedation, fatigue and dizziness. There can also be side effects such as dry mouth, indigestion and nausea. Occasionally it slows the heart rate down and lowers the blood pressure, because after all, that's what these medications were designed for. There can also be nightmares and insomnia. Anxiety can be seen, depression. Rarely hallucinations. And if you suddenly stop these medications, the blood pressure can go up and become hypertension. So again, these medications can be very effective, but the side effects need to be managed very, very closely. And again, this is another important feature of these agents, that they improve neurotransmission throughout the day, and can also have beneficial effects on things like aggression and tics.

Im sure you will understand it far better than me.

Smokeyoaks
09-24-13, 07:26 PM
I just got a prescription for Kapvay today from my doctor after being on vyvanse 50mg for a little over a month and seeing no help with hyperactivity and an actual increase in anxiety. I've actually started to notice some obsessive tendencies since being on vyvanse and this worries me. There isn't much info on adults taking kapvay since it is a new drug but supposedly it will help calm the anxiety and hyperactivity so that I am better able to function on the vyvanse during the day.

I wonder if anyone knows exactly how kapvay works for adults (I'm 19) on vyvanse and if it's anyone would recommend it as an additive or if I'm better off without it. Thanks!

Nicksgonefishin
01-26-14, 10:39 PM
I just got a prescription for Kapvay today from my doctor after being on vyvanse 50mg for a little over a month and seeing no help with hyperactivity and an actual increase in anxiety. I've actually started to notice some obsessive tendencies since being on vyvanse and this worries me. There isn't much info on adults taking kapvay since it is a new drug but supposedly it will help calm the anxiety and hyperactivity so that I am better able to function on the vyvanse during the day.

I wonder if anyone knows exactly how kapvay works for adults (I'm 19) on vyvanse and if it's anyone would recommend it as an additive or if I'm better off without it. Thanks!


I was wondering the same thing about clonodine... Came across it while searching for nicotine withdrawal solutions in ADHD...

Austinnou88
12-04-14, 07:40 PM
I'm starting to get side effects from straterra, You think adding clonidine might help make them go away?

j_dubs
12-29-14, 04:10 AM
I'm on .2 - .4 mg of Clonidine a day for sleep. I don't like to mix them with my Dextroamphetamine during the day though. However when I was on the Barr Adderall I would get such bad sides sometimes I would whenever they hit. Now I'm on Dex there's no need. I combine the Clonidine with 15-25 mg of Seroquel (I split it in half) works wonders for sleep. In answer to the Strattera question yes, it most likely would I would figure...

2metersofstupid
12-31-14, 08:59 PM
Wait, so we're reducing NE, but optimizing NE utilization, if I understand it correctly?

And what about some possible Clonidine agonism at postsynaptic area?
Apparently, typical stimulants can override the agonism of autoreceptor, and you're left with already agonistic postsynaptic property of Clonidine, as I understand it?

So why in the hell would Strattera, an NRI, which increases NE (or actually keeps more in the loop), be prescribed, if this can help?

Steppe
04-16-16, 01:05 PM
For me it gives a few second delay on internal automatic loops being triggered.
Its like a fuse box effect, by the time a person or situation blows the 4th or 5th
fuse you can still have time to decide; invest in this or move on.

Tactile sensation is like being in a swimming pool with a mask, snorkel and fins.
If heavy stress and legions of emotional button pushers are straight ahead its
a worthy chill tool that avoids the benzo trap.

Postulate
02-02-17, 08:22 PM
I'll explain it in simply terms: If you can afford a drop in blood pressure, Clonidine or intuniv will help with your ADHD. You don't have to talk about norepinephrine because Clonidine's mode of action goes beyond the scope of even a PhD theses. Just remember:

If you can afford a drop in blood pressure, Clonidine or intuniv will help with your ADHD.