Clonidine Benefits Children with Attention Deficit Disorder and Hyperactivity: Report of a Double-Blind Placebo-Crossover Therapeutic Trial

Ten children ages 8–13 years with attention deficit disorder and hyperactivity (ADDH) completed a double-blind placebo-controlled crossover trial consisting of clonidine for 8 weeks and placebo for 4 weeks. The diagnosis was established through a standardized clinical interview with parents and children by two child psychiatrists and behavior ratings by parents and teachers. Parents' behavior ratings showed that 7 of the 10 children clearly benefited from clonidine. The total score of behavior ratings on Conners' Scale for the group diminished from pretreatment levels of 66.85 ± 5.75 (mean ± S.E.) to 43.00 ± 6.29 by the end of active clonidine treatment ( p = 0.001). Parents rated as the greatest improvement in factors comprising the Hyperactivity Index, and Conduct Problems. Of the 8 children on whom teachers' ratings were completed, 7 improved with clonidine. Teachers' overall ratings for the ADDH group before clondidine were 49.00 ± 5.2 and decreased to 25.79 ± 1.3 by the last 2 weeks of active treatment ( p = 0.001). Teachers' ratings of the "Hyperactivity Index" decreased even more significantly (1.99 ± 0.16) to 1.12 ± 0.06 by the end of active clondidine treatment ( p = 0.001). The major side effect was sleepiness, which diminished in all but one child by the third week of treatment. Clonidine appears to be a safe, effective medication for a subgroup of children with symptoms of ADDH. Its effectiveness suggests the importance of the norepinephrine system in the pathophysiology of the cognitive and behavioral disturbances in some children with ADDH. Journal of the American Academy of Child Psychiatry , 24, 5:617–629, 1985.