On wider use of clonidine

Case: 49 year old female is admitted to ICU with mental status change. She was intubated in ER. Relatively she has no past medical history except recently started on Clonidine for relief of menopausal symptoms!


Comment: Recently clonidine has found many off-label uses including neuropathic pain, opioid detoxification, sleep hyperhidrosis, insomnia, relief of menopausal symptoms, ADHD and others.

Clonidine toxicity may have many central and cardiac effects like bradycardia, AV nodal block, Wenckebach, tachycardia, hypotension, transient hypertension, hypothermia, CNS depression, hyporeflexia, seizures, respiratory depression etc.

Treatment is mostly supportive but 2 antidotes which may help includes Narcan (Naloxone) and Yohimbine.