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Clonidine is not a Useful Adjunct to Methadone Gradual Detoxification in Opioid Addiction

Published online by Cambridge University Press:  02 January 2018

Hamid Ghodse ,
Judith Myles  and
Stephen E. Smith
Hamid Ghodse*
Affiliation:
St George's Hospital Medical School
Judith Myles
Affiliation:
St George's Hospital Medical School
Stephen E. Smith
Affiliation:
United Medical & Dental Schools (St Thomas' Campus), London
*
Professor Ghodse, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE
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Abstract

Background

The role of clonidine in the management of opioid-dependent individuals undergoing gradual detoxification.

Method

A double-blind placebo-controlled trial was conducted on 86 voluntary in-patients (59 male, 27 female) aged 18–47 years, at a specialist drug-dependence treatment unit. Patients entered the trial when on 40 mg of methadone daily or less, and were randomised to receive incremental doses of clonidine (increasing from 0.2 mg daily to 1.2 mg daily) during a 14-day period of gradual methadone detoxification and for four weeks thereafter. Blood pressure was monitored and severity of opioid abstinence was assessed by questionnaire and by clinical examination.

Result

Half the subjects were withdrawn or defaulted from the trial by the end of two weeks, those receiving clonidine earlier than those receiving dummy medication (9 of the former and only one of the latter because of systemic hypotension). Similar proportions of subjects completed detoxification in the two groups. In those who completed detoxification, clonidine did not significantly reduce either the symptoms or objective signs of opioid withdrawal.

Conclusions

These findings suggest that clonidine has no place as an adjunct to a programme of gradual opioid detoxification.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue 3 , September 1994 , pp. 370 - 374
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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References

Bjorkvist, S. E. (1975) Clonidine in alcohol withdrawal. Acta Psychiatrica Scandinavica, 52, 256–263.CrossRefGoogle Scholar
Glassman, A. H., Stetner, F., Walsh, B. T., et al (1988) Heavy smokers, smoking cessation, and clonidine. Journal of the American Medical Association, 259, 2863–2866.Google Scholar
Gold, M. S., Redmond, D. E. & Kleiber, H. D. (1978a) Clonidine in opiate withdrawal. Lancet, i, 929–930.Google Scholar
Gold, M. S., Redmond, D. E. & Kleiber, H. D. (1978b) Clonidine blocks acute opiate-withdrawal symptoms. Lancet, ii, 599–602.Google Scholar
Gold, M. S., Pottash, A. L., Sweeney, D. R., et al (1980) Opiate withdrawal using clonidine. A safe, effective, and rapid nonopiate treatment. Journal of the American Medical Association, 243, 343–346.Google Scholar
Gold, M. S., Pottash, A. L., Exteira, I., et al (1981) Clonidine in opiate withdrawal. Current Psychiatric Therapy, 20, 939–941.Google Scholar
Hunyor, S. N., Hansson, L., Harrison, T. S., et al (1973) Effects of clonidine withdrawal: possible mechanisms and suggestions for management. British Medical Journal, 2, 209–211.CrossRefGoogle ScholarPubMed
Jasinski, D. R., Johnson, R. E. & Kocher, T. R. (1985) Clonidine in morphine withdrawal. Differential effects on signs and symptoms. Archives of General Psychiatry, 42, 1063–1066.Google Scholar
Oruish, S. A., Zisook, S. & McAdams, L. A. (1988) Effects of transdermal clonidine treatment on withdrawal symptoms associated with smoking cessation. A randomized controlled trial. Archives of Internal Medicine, 148, 2027–2031.Google Scholar
Reid, J. L., Wing, L. M. H., Dargie, H. J., et al (1977) Clonidine withdrawal in hypertension. Changes in blood pressure and plasma and urinary noradrenaline. Lancet, i, 1171–1174.Google Scholar
Rounsaville, B. J., Kosten, T. & Kleber, H. (1985) Success and failure at outpatient opioid detoxification. Evaluating the process of clonidine- and methadone-assisted withdrawal. Journal of Nervous and Mental Diseases, 173, 103–110.Google Scholar
Washton, A. M. & Resnick, R. B. (1980) Clonidine for opiate detoxification: out-patient clinical trials. American Journal of Psychiatry, 137, 1121–1122.Google Scholar
Wei, H. & Young, D. (1988) Effect of clonidine on cigarette cessation and in the alleviation of withdrawal symptoms. British Journal of Addiction, 83, 1221–1226.Google Scholar
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