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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by chess on May 11, 2005, at 10:59:21
anybody ever use clonidine for anxiety or know if it's helpful for GAD?
Posted by sdb on May 11, 2005, at 13:54:39
In reply to Clonidine for anxiety?, posted by chess on May 11, 2005, at 10:59:21
Hi!
Yes it helps to control noradrenaline release, it is a alpha2-agonist. It has influence of Nucleus coeruleus, which controls with some long "nerves" the brain and the spine.
It does not diminish anxiety but it can be helpful for example performance anxiety (trembling, sweating, heart pounding). You could combine it (low dosage) with a betablocker. Less noradrenaline can cause depression. I have taken clonidine temporarely to see what it does. It did not affect my mood, i only had dry mouth and otherwise almost no sideffects. There is another alpha2-agonist guanfacine, which can (according to studies) even improve memory and cognitive performance through more blood flow in the frontal cortex. I am not sure but it even has longer half-life and it is more selective (check this). Normaly a2-agonists are used in hypertension or years ago to calm animals during examinations. I personally had no problem stopping the clonidine immediately combined with very small dosage of nadolol. It could be also useful in ADHD and perhaps combined with lipophil betablockers against emotional shocks. Betareceptors and norepinephrine has influence on memorizing bad emotional shocks. I would take only small dosages in the beginning to see what it does. Normally two dosages in the beginning per day is recommended.
I personally had a bad panic attack caused by mirtazapine which has strong alpha2-antagonist properties (this should be activating and therefore good for depression but it did the wrong thing during an oral performance, heart pounding, almost jumping on the roof...). Above all mirtazapine is an interesting med in small dosages). My strong believe is (because of the bad experience during performance with an alpha2-antagonist), that alpha2-agonists could be helpful to diminish physical symptoms thus, helpful for you if it is tolerable (blood-pressure, no depression).
I used it only occasionlly i don't know what i would do in the long term.Kind regards
sdb
Posted by Chairman_MAO on May 11, 2005, at 20:16:48
In reply to Clonidine for anxiety?, posted by chess on May 11, 2005, at 10:59:21
It is of limited use, but tends to induce depression, fatigue, impotence, etc--not to mention hypotension!
Posted by SLS on May 12, 2005, at 6:59:19
In reply to Re: Clonidine for anxiety? » chess, posted by Chairman_MAO on May 11, 2005, at 20:16:48
> It is of limited use, but tends to induce depression, fatigue, impotence, etc--not to mention hypotension!
I agree.
What syndrome, specifically, is to be treated here? Anxiety is a component of many different conditions.
- Scott
Posted by chess on May 12, 2005, at 7:31:13
In reply to Re: Clonidine for anxiety?, posted by SLS on May 12, 2005, at 6:59:19
I primarily have GAD/PAD and OCD (pure-O) and then have some depression on as result of GAD/PAD
>
> What syndrome, specifically, is to be treated here? Anxiety is a component of many different conditions.
>
> > > It is of limited use, but tends to induce depression, fatigue, impotence, etc--not to mention hypotension!>
Posted by sdb on May 12, 2005, at 7:43:11
In reply to Re: Clonidine for anxiety?, posted by sdb on May 11, 2005, at 13:54:39
I give only experiences of drugs, which I have taken myself when it seems somebody want to take this drug.
As I said before I had following symptoms during a test of only <7 days>.
-dry mouth
-no depression
-slightly reduced sympathicus
-no aprupt hypotension, in spite very low dosage comedication of nadolol after stopping it immediately (I normally have without medication minor hypotension).
-no remarkable reduction in anxiety
-Perhaps some reduced physical symptoms of anxiety but I have not tested it seriously during performance.
-I took only 0.075mg (half a pill of 0.15mg)You stated "clonidine for anxiety". I responded to the title of your thread.
Kind regards
sdb
Posted by Chairman_MAO on May 12, 2005, at 20:53:39
In reply to Re: Clonidine for anxiety?, posted by sdb on May 11, 2005, at 13:54:39
Yohimbine has been used to POTENTIATE phobic responses or recall of trauma in order to desensitize the patient to the noxious stimuli/thoughts. I believe that sort of therapy has had some success.
A2 antagonists increase emotionally-based recall of memories, and can serve--as you found out--as a probe to find out if one is especially vulnerable to panic attacks. It's fascinating stuff.
I am not sure that a2 agonists have any utility in treating panic disorder, though.
This whole picture is complicated by the imidazoline receptor system, which clonidine also affects (I think). The endogenous "clonidine displacing substance", agmatine (decarboxylated l-arginine), is fascinating: it attenuates opioid tolerance/dependence, is slightly hypotensive (like clonidine), is an NMDA receptor antagonist, regulates Ca2+ influx, inhibits neural nitric oxide synthase, and more. I have tried this stuff (in the sulfate form), and it does potentiate the buprenorphine I am on at a dose of 500mg.
While there is certainly promise for more metabolically stable agmatine analogs to be used therapeutically, the therapeutic use of clonidine is limited due to concerns of inducing depression, which I think it can do even in people without a history of depression. Its beneficial effectgs also may be subject to tolerance, but I am not sure about that.
Moral of the story: Use a beta blocker or a benzo. Wait for agmatine-mimetics, use gaunfacine, or take a benzo. Clonidine is interesting for research but not too practical clinically.
Posted by sdb on May 13, 2005, at 1:16:18
In reply to Re: Clonidine for anxiety? » sdb, posted by Chairman_MAO on May 12, 2005, at 20:53:39
I agree with Chairman_MAO.
If you want to diminish the physical symptoms of anxiety I would use:
A betablocker (nadolol or slow oxprenolol in the long term), perhaps combined with guanfacine or if guanfacine is not available clonidine. Control your bloodpressure (I dont know about your cardiovascular condition-> be careful), but I personally had never problems combining such drugs. I had only a problem with sildenafil, which caused hypotension crisis when I arrived at the warm home after riding with my motorbike in the winter times(-16 degrees). I am physically sportive so it did not kill me...
If you want to diminish anxiety itself use a benzo combined with low dosage of a betablocker (nadolol) or perhaps a MAO. I can not give you recommendations for benzos and MAO's. I have taken not so many benzos and not for a long time. The only MAO I took (moclobemide) did nothing. Ask darkhorse for benzo questions or Chairman_MAO for MAO questions!
Posted by sdb on May 13, 2005, at 1:31:14
In reply to Re: Clonidine for anxiety? » sdb, posted by Chairman_MAO on May 12, 2005, at 20:53:39
Chairman_MAO,
Thank you for the agmatine information. I will note this and eventually ask you about your experiences later (I am currently trying a low dosage benzo combination).
Kind regards
sdb
This is the end of the thread.
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