clonidine / Generic mfg. - LARVOL DELTA

literature review of peri-operative preparation and premedication in children with autism spectrum disorder (ASD) (Euroanaesthesia 2025) - "The retrospective studies of premedication found a pattern of atypical use with frequent intramuscular or intranasal administration of ketamine. In day case procedures, excellent results were recorded with the use of alpha-2 agonists such as clonidine and dexmedetomidine as the sedative agent in both prospective and retrospective studies. This review supports the need for better preparation using principles of cognitive behavioural therapy, social stories with individualised reward as motivator and desensitisation using toy/fake cannulation kits... This review supports the need for better preparation using principles of cognitive behavioural therapy, social stories with individualised reward as motivator and desensitisation using toy/fake cannulation kits. Most of these are low cost strategies that can prevent harm and higher health care costs. We suggest they should be implemented and evaluated in all settings providing procedural care to children and young people with..."

Clinical • Review • Autism Spectrum Disorder • Genetic Disorders

Comparative evaluation of analgesic efficacy of the ultrasound guided erector spinae plane(ESP) block versus transversus abdominis plane(TAP) block in children undergoing unilateral abdominal surgeries: a prospective randomised controlled trial (Euroanaesthesia 2025) - "Patients randomised into Group E (n= 35 patients) and Group T (n= 35 patients) received ultrasound-guided unilateral ESP block and unilateral TAP block respectively using 0.5ml/kg of 0.25% Ropivacaine plus Clonidine1µ/kg after general anaesthesia.Primary objective was to compare the duration of analgesia (time to first rescue analgesia requirement) of ultrasound-guided ESP Vs TAP block in children undergoing unilateral abdominal surgeries. The secondary objectives were the trend of intraoperative hemodynamic parameters, total fentanyl consumption in the first 24 hours, FLACC scores at 0, 2hrs, 4hrs, 6hrs, 12hrs and 24 hours in children up to 7 years and VAS scores at the same point of times in children more than 7 years, duration of putting block (needling time), parental satisfaction and incidence of any side effects.Results and The median (IQR) time to first rescue analgesia requirement was 30 min (30min-120min) in Group E and 30 min (30min -75min) in Group T (p..."

Clinical • Surgery • Anesthesia • Pain • Pediatrics

Opioid resistance in a patient with prolonged cessation of oral naltrexone use: a case report (Euroanaesthesia 2025) - "This pattern repeated, necessitating high doses of opioids (Sufentanil 0.7 mcg/kg, Remifentanil 1.5 mg) and adjuvants (Ketamine 0.55 mg/kg, Clonidine 1 mg/kg, Lidocaine 1.38 mg/kg). At the end of the procedure, extubation occurred without complications, 15 minutes after discontinuing Propofol.Postoperatively, she experienced severe pain (7/10), treated with morphine, ketorolac, and dipyrone, yielding partial relief. Later, she disclosed prior use of high-dose Naltrexone (64 mg/day) and Bupropion (720 mg/day) for five months before stopping. The findings suggest prolonged Naltrexone effects, including opioid resistance persisting after its cessation. This resistance may result from extended use and high dosing, highlighting the need for revised perioperative management protocols in patients discontinuing Naltrexone."

Case report • Clinical • Anesthesia • Movement Disorders • Pain • Psychiatry

Low opioid anaesthesia in bariatric patients: a retrospective cohort study (Euroanaesthesia 2025) - "We defined LOA as "an effort to reach a TCI dose of 2 ng/ml remifentanil intraoperatively without other opioids". Standardised doses of non-opioid analgesia were administered to the LOA group; 600mg magnesium, 100mg lidocaine, 150µg clonidine and 10mg S-ketamine...Paracetamol, ketorolac and dexamethasone were the same in both groups... Implementation of standardised LOA significantly reduced postoperative morphine requirements, the need for supplemental oxygen administration, as well as reducing the PACU LOS in bariatric patients. This method effectively introduced LOA without requiring additional resources, yielding clear benefits for patients."

Retrospective data • Anesthesia • CNS Disorders • Depression • Genetic Disorders • Obesity • Psychiatry

Evaluating the efficacy of clonidine premedication in reducing emergence delirium in children: a retrospective analysis (Euroanaesthesia 2025) - "Background and Goal of Study: Emergence delirium (ED) is a common and distressing postoperative complication in children, characterized by agitation and disorientation, with potential implications for recovery, safety, and postoperative behavior. However, compared to other common premedications such as midazolam, its potential benefits in analgesic sparing and postoperative recovery warrant further investigation in targeted populations. These findings can contribute to preoperative management strategies in pediatric anesthesia."

Retrospective data • Anesthesia • CNS Disorders • Pain • Pediatrics • Psychiatry

The use of intravenous clonidine in postoperative pain management: a scoping review (Euroanaesthesia 2025) - "Findings are specific for major elective surgeries with no specific indications for use. The reported evidence shows little effect of clonidine on pain scores and supplemental analgesia."

Review • Pain

Investigating the association between clonidine premedication and the risk of perioperative respiratory adverse events in children: A retrospective cohort study (Euroanaesthesia 2025) - "Our results suggest that clonidine premedication does not significantly alter the risk of PRAE in pediatric patients.Conclusion(s): Clonidine premedication was not significantly associated with the incidence of perioperative respiratory adverse events, either overall or during the immediate postoperative period. These findings from our retrospective propensity score-matched analysis contribute to evidence supporting the safety profile of clonidine, suggesting that it does not increase the risk of PRAE in pediatric patients."

Adverse events • Retrospective data • Anesthesia • Pediatrics • Psychiatry

Efficacy, side effects and safety of intrathecal clonidine for caesarean delivery: a 12-year retrospective study (Euroanaesthesia 2025) - "Deliveries were grouped: hyperbaric bupivacaine (HB) with clonidine (clonidine group), HB with lipophilic opioids (sufentanil or fentanyl) (opioid group) and HB only (HB-only group). Intrathecal clonidine and lipophilic opioids provide similar improvements to anaesthetic block. However, intrathecal clonidine increases the risk of hypotension. We suggest that its use should be reserved for selected cases."

Adverse events • Retrospective data • Anesthesia • Hypotension

New frontiers in pharmacological treatment of attention-deficit hyperactivity disorder. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Clinical efficacy, safety profiles, and advancements in technology-based interventions were analyzed. Stimulant medications, such as methylphenidate and amphetamines, remain the mainstay of ADHD treatment but pose risks of abuse and dependence. Non-stimulant options, including atomoxetine and extended-release α-2 agonists like guanfacine and clonidine, provide alternatives for patients who cannot tolerate stimulants. Emerging therapeutic devices, including the Monarch eTNS System and EndeavorRx, offer innovative drug-free treatment options. The prognosis for ADHD is variable, with some individuals experiencing symptom resolution while others continue to face lifelong challenges. A multidisciplinary approach that integrates pharmacotherapy, behavioral therapy, and novel technology-based interventions holds promise for improving patient outcomes and addressing the societal impact of ADHD."

Journal • Review • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Developmental Disorders • Psychiatry

Non concordant side in concomitant Mild Autonomous Cortisol Secretion and Primary Aldosteronism: How should we prioritize treatment? (ENDO 2025) - "His medication regimen included Nifedipine XL 90 mg daily, Carvedilol 12.5 mg twice daily, Doxazosin 2 mg daily, Clonidine 0.1 mg daily, Eplerenone 100 mg twice daily, Losartan 50 mg daily, and Potassium 60 mEq daily...A 1 mg-dexamethasone suppression (DST) test revealed an elevated cortisol level (6.6 mcg/dL) and an appropriate dexamethasone level (255 ng/dL), consistent with Mild Autonomous Cortisol Secretion (MACS)... While surgical adrenalectomy may reverse cardiac remodeling in patients with PA and concurrent MACS, there is limited guidance on how to prioritize treatment when hormone excess originates from different adrenal glands. In such cases, clinical judgment and an individualized approach are essential, along with optimal medical management to mitigate long-term complications and risks."

Discordant • Adrenal Cortex Carcinoma • Cardiovascular • Congestive Heart Failure • Cushing’s Disease • Endocrine Cancer • Endocrine Disorders • Fatigue • Heart Failure • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Myocardial Infarction • Oncology • Orthopedics • Solid Tumor

Adrenal Vein Sampling and Surgical Outcomes in Mild Autonomous Cortisol Secretion: A Case Series (ENDO 2025) - "Dexamethasone suppression cortisol value was 5.7, and patient demonstrated no clinical features of overt Cushing's syndrome...Hypertension medications included amlodipine/benazepril 10-40mg, clonidine 0.1mg twice a day, and hydralazine 10mg 3 times a day...By 5/2023, BP continued improving to 129/78, BMI decreased to 29.7 and medications included amlodipine/benazepril 10-40mg, hydralazine 50mg 3 times daily, and doxazosin 4mg.Case 2:55yo male with a right adrenal nodule (1.0 × 0.6 cm)...At 2 months post-op, BP was well controlled on only nifedipine 30mg and doxazosin 4mg once daily...AVS guided adrenalX in MACS resulted in BP improvement and stable BMI, with varying degrees of antihypertensive reduction. AVS remains a promising tool for guiding surgical decisions in adrenal nodules with subclinical cortisol excess. With additional research the full potential of AVS in guiding adrenalX may be realized."

Clinical • Anemia • Cardiovascular • Cushing’s Disease • Endocrine Disorders • Hematological Disorders • Hypertension • Hypoglycemia • Pain

MAPLE: Mitigating the Pro-inflammatory Phenotype of Obesity (clinicaltrials.gov) - P1 | N=60 | Recruiting | Sponsor: University of Kansas Medical Center | Trial completion date: Jul 2025 ➔ Aug 2027 | Trial primary completion date: Jul 2025 ➔ Aug 2026

Trial completion date • Trial primary completion date • Diabetes • Genetic Disorders • Metabolic Disorders • Obesity

A Framework for the Modulation and Alleviation of Pain Sensations: A Narrative Review. (PubMed, Cureus) - "Apart from pharmaceutical treatments like corticosteroids, clonidine-enhanced local anesthetics, and innovative methods that target peripheral and central pain pathways, significant developments include the use of intracanal cryotherapy, low-level laser therapy (LLLT), and photobiomodulation...Additionally, the review highlights the significance of the intensity of pain prior to surgery, the effectiveness of supplemental treatments such as nano-pulsed lasers, and the importance of patient-specific variables in maximizing pain management. This review includes evidence-based, multimodal solutions to improve patient outcomes and promote a pain-free dental experience by combining state-of-the-art clinical trials, systematic reviews, and meta-analyses."

Journal • Review • Anesthesia • Pain

Comparison of Oral Preoperative Clonidine with Infusion of Intraoperative Labetalol on Bleeding during Tympanoplasty Surgery. (PubMed, Iran J Otorhinolaryngol) - "Premedication with clonidine or labetalol is associated with reduced intraoperative bleeding, improved surgical field visibility, and shorter duration of tympanoplasty procedures. This may potentially lead to increased satisfaction and success rates of the operation."

Journal • Anesthesia • Otorhinolaryngology

Additive Effects of Clonidine Used in Propofol Sedation in Colonoscopy. (PubMed, Anesth Pain Med) - "However, Aldrete scores in the post-anesthesia care unit (PACU) were lower in G2 (P = 0.001), suggesting a slower recovery. The addition of clonidine to propofol for colonoscopy sedation led to faster sedation onset, reduced propofol requirements, improved patient satisfaction, and deeper sedation, but with potentially prolonged recovery times."

Clinical • Journal • Anesthesia

Is L-dopa test effective in detecting adrenal insufficiency with preliminary diagnosis of growth hormone deficiency in children with short stature? (PubMed, J Pediatr Endocrinol Metab) - "The L-dopa stimulation test may represent a valuable adjunctive tool for the evaluation of cortisol sufficiency in children undergoing assessment for suspected GH deficiency. However, further prospective studies with larger sample sizes and standardized protocols are warranted to validate its diagnostic accuracy and clinical utility in detecting adrenal insufficiency."

Journal • Endocrine Disorders • Growth Hormone Deficiency • Growth Hormone Deficiency (Pediatric) • Nephrology • Pediatrics • Renal Disease

Sex Differences in Catecholamine Induced Fat Cell Lipolysis (ECO 2025) - "The cells were incubated in the absence (basal) or presence of increasing concentrations of the following agents acting though cyclic AMP: noradrenaline (natural hormone), isoprenaline (non-selective lipolytic beta-adrenoceptor agonist), dobutamine (selective lipolytic beta-1 adrenoceptor agonist), terbutaline (selective beta-2 adrenoceptor agonist), clonidine (selective antilipolytic alpha-2A adrenoceptor agonist), forskolin (selective lipolytic stimulator of adenylyl cyclase) and dibutyl cyclic AMP (phosphodiesterase resistant lipolytic cyclic AMP analogue which stimulates protein kinase A). There are marked and complex sex differences regarding catecholamine stimulated lipolysis in subcutaneous fat cells. The lipolytic sensitivity is 50% decreased in women because of increased function and/ or coupling to Gi-protein of alpha-2A adrenoceptors. However, the beta adrenoceptor mediated maximum lipolytic action of the hormones is 50% enhanced in women owing to increased..."

Cardiovascular • Metabolic Disorders

Contractile effects of dexmedetomidine in the human heart. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Dexmedetomidine is an approved drug that is chemically related to clonidine...These effects were increased by previously applied cilostamide and slightly attenuated by subsequently applied 10 µM cimetidine but greatly attenuated by 10 µM propranolol or when first 10 µM cocaine was given...Dexmedetomidine can probably, in principle, release endogenous cardiac noradrenaline. Thus, dexmedetomidine can act as a partial agonist at human cardiac H2-histamine receptors but its main effect in HAP is the release of endogenous β-adrenergic catecholamines."

Journal • Anesthesia

Alpha-2 agonists for refractory neurological symptoms in pediatric palliative care: a scoping review. (PubMed, Front Pediatr) - "Two drugs (dexmedetomidine, n = 4/7, and clonidine, n = 3/7) were investigated, encompassing a total of 44 patients aged between 7 months and 18 years. Alpha-2 agonists are increasingly being used to manage intractable neurological symptoms in pediatric palliative care. However, evidence regarding their safety profile and effectiveness remains limited, highlighting the need for further research in this area."

Journal • Review • CNS Disorders • Dystonia • Movement Disorders • Palliative care • Pediatrics

Presynaptic release-regulating α2 receptors and Urolithins: A bridge between systemic EA administration and central health properties. (PubMed, Biomed Pharmacother) - "Notably, central effects were associated to a significant changes in gut microbiome composition, towards a metabotype that would preferentially produce UroA. Based on these observations, we propose UroA as one of the systemic "effectors" of the EAm-induced central noradrenergic adaptation, confirming the role of noradrenaline in mediating the EA-mediated health effects."

Journal

Kleine-Levin Syndrome: A Clinical Challenge in Pediatric Hypersomnia (ATS 2025) - "Patient was taking stimulants and clonidine; however, discontinuation of clonidine did not alleviate hypersomnia...Carbamazepine was initiated due to concerns for KLS...Moreover, the patient's clinical history, including episodes of hypersomnia and atypical behavior, underscores the complexity of diagnosing KLS in younger populations, where the typical presentation may be obscured by coexisting conditions such as ADHD. This case highlights the importance of considering KLS diagnosis at this age to ensure they receive appropriate care and resources to navigate their condition effectively."

Clinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Infectious Disease • Mental Retardation • Migraine • Pain • Pediatrics • Sleep Disorder

Management Challenges in Severe Serotonin Syndrome: A Case Report and Literature Review (APA 2025) - "Her husband reported that she had taken approximately 70 Wellbutrin XL 150mg following...When attempting to taper off sedation, Dexmedetomidine, due to its prolonged use for over 24 hours,it caused withdrawal symptoms, resulting in severe agitation and vital signs instability...We selected Guanfacine over Clonidine which was an effective option as well; but could lead to hypotension (reported rates as high as 44%)...High-dose Benzodiazepines were then initiated as the mainstay of treatment with Lorazepam dose 2mg IV QID. In addition, Gabapentin was added for potentially offering presynaptic inhibitory effects on Glutamatergic neurons...Hydralazine should have been avoided due to its significant inhibitory effects on MAO which could exacerbate serotonin toxicity. Instead, the patient would benefit of rapidly-acting medications with short half-lives, such as Esmolol, particularly to mitigate the risk of hypotension."

Case report • Clinical • Review • Addiction (Opioid and Alcohol) • Anesthesia • Cardiovascular • CNS Disorders • Depression • Epilepsy • General Anxiety Disorder • Hypotension • Major Depressive Disorder • Mood Disorders • Psychiatry

Grinding Gears: A Systematic Review of Clinical Trials on Pharmacotherapy for Sleep Bruxism (APA 2025) - "Gabapentin 300 mg, Clonidine 0.3 mg, Rabeprazole 10 mg, and Methazolamide 100 mg were effective for sleep bruxism in adults...In children, Hydroxyzine was effective, while Diazepam was not...Phytolacca decandra and Propranolol were ineffective, and Pramipexole was ineffective and disrupted sleep...Clonazepam could be considered in patients with concurrent sleep initiation insomnia...Sleep bruxism is often linked with psychiatric conditions, but most trials excluded these disorders. Double-blinded trials with larger samples, including patients with anxiety and depressive disorders, are needed for more definitive guidance."

Clinical • Review • CNS Disorders • Dental Disorders • Depression • Insomnia • Mood Disorders • Pain • Psychiatry • Sleep Disorder

Abuse of Over-the-Counter Medications a Case Series Including Recommendations for Treatment (APA 2025) - "Psychiatry recommended olanzapine and quetiapine as needed for agitation. Home medications, valproic acid and donepezil, were resumed...of the cases utilized a taper which was limited to or included DPH, while others made use of other anticholinergic medications including benztropine. Benzodiazepines as well as clonidine were used to attenuate the responses of the central nervous system. Nine cases of DPH abuse are summarized in the table. Only adults who misused oral DPH were included. Taper range varied from "a few" days to 126 days."

Clinical • Acute Kidney Injury • Anemia • Anesthesia • Cardiovascular • CNS Disorders • Depression • Diabetes • Dyslipidemia • Familial Chylomicronemia Syndrome • Hematological Disorders • Hypertension • Major Depressive Disorder • Metabolic Disorders • Movement Disorders • Nephrology • Pain • Psychiatry • Renal Disease • Type 2 Diabetes Mellitus • Urinary Incontinence • Urology

Paroxysmal Sympathetic Hyperactivity Syndrome (PSHS). Management Strategies (ATS 2025) - "Management strategy; morphine test at 90% of patients, dexmedetomidine infusion 90% of patients received this medication at first line of treatment, pregabalin 70%, clonidine 50%, propranolol 40%, morphine rescue dose 70%. In patients with severe acute brain injury, the occurrence of SHPS is common, with a higher prevalence in patients with a GCS score of 7 points. In patients with severe acute brain injury, the occurrence of SHPS is common, with a higher prevalence in patients with a GCS score of 7 points. Symptoms typically start around 9 days after the acute injury. Once this clinical entity is identified through the Clinical Feature Scale, once management strategies are implemented, crises are resolved in 80% of cases by the fourth day of treatment."

Cardiovascular • Hypertension • Movement Disorders • Psychiatry • Vascular Neurology