Clonidine is a central α2-receptor agonist that inhibits the synthesis and release of norepinephrine through presynaptic α2-receptor stimulation. Besides treating tic disorders, it also improves comorbid attention deficit and hyperactivity. Though its efficacy in treating tics may not match that of haloperidol, clonidine is safer, and its long-term effects need further observation. Due to the absence of tardive dyskinesia risk, it is often preferred for mild to moderate tic disorders, particularly in cases with comorbid ADHD.
Clonidine is available in oral tablets and transdermal patches. The patches reduce the discomfort of medication, enhancing compliance, especially in younger children with tic disorders.
In the early stages of high-dose oral clonidine treatment, side effects such as sedation, irritability, headache, and hypotension may occur.
Due to its short half-life, some patients may experience mild withdrawal symptoms between doses.
A small number of patients may develop arrhythmias or experience worsening pre-existing arrhythmias while taking clonidine. It is essential to monitor heart rate during treatment and gradually reduce the dosage if side effects occur. Red rashes are common adverse reactions to clonidine patches. Clean the skin before applying the patch, and if an allergic reaction occurs, change the application site.