Catapres (clonidine) is a versatile medication originally used to lower blood pressure. In the decades since its release uses have expanded to include a variety of psychiatric disorders, pain management, sedation, withdrawal symptoms, menopause symptoms, and numerous other applications. It can be used in patients as young as 6 years old.

Catapres tablets are typically taken twice per day, morning and afternoon or evening. The medication is also available in patches.

Conditions Treated

Catapres is often prescribed to lower blood pressure or to reduce symptoms of attention deficit hyperactivity disorder (ADHD). Other applications are frequent, however, and the drug is being investigated for use in even more conditions.

Common uses include:

• Lowering blood pressure
• Alleviating disruptive symptoms of ADHD
• Alleviating insomnia resulting from stimulant use (such as other ADHD medications)
• Reducing hyperarousal in conditions like post-traumatic stress disorder (PTSD)
• Reducing tics in Tourette syndrome
• Alleviating withdrawal symptoms of opioids, nicotine, benzodiazepines and alcohol
• Alleviating symptoms of perimenopause/menopause
• Alleviating physical and mental symptoms of a range of anxiety-related disorders
• Reducing the frequency and severity of migraine headaches
• Reducing the severity of restless legs syndrome
• Reducing symptoms of bipolar disorder, obsessive-compulsive disorder, and other psychiatric disorders.
• Alleviating neuropathic pain and other chronic pain

The exact mechanism by which Catapres works in most of the above conditions isn't entirely understood. It inhibits the body's release of adrenaline, which relaxes blood vessels and decreases the heart's workload, hence its blood pressure-reducing properties; adrenaline inhibition may also explain some of its pain-reducing effects. Less clear is how it improves impulse control and mental focus, and it is thought to have additional pain-reducing properties as well.

Treatment Overview

Catapres is administered in very small doses, measured in micrograms (mcg) rather than milligrams (mg). It can be administered via tablet, patch, or injection. Patches and injections are most commonly used for pain management, tablets are the least effective form of administration in this application.

Tablets are taken twice per day. Many patients find Catapres induces drowsiness and may need to take a stimulant with the morning dose. Afternoon or evening doses are often helpful for winding down if other stimulant medications were taken earlier in the day.

In tablets and patches dosage typically ranges from 200 to 600 mcg per day; the ideal dosage depends on patient response. The vast majority of patients are started on 200 mcg per day, 100 mcg in the morning and another in the afternoon or evening. The medication should be taken for at least a week before effects are evaluated and dosage adjustments made, assuming, of course, that no serious side effects develop. It takes about four weeks for full benefits to be seen.

Treatment may continue for as long as it provides benefit, be that weeks or years. Note that treatment should not stop abruptly.

Warnings Before Use

Like all medications Catapres does carry risk of side effects and interactions with other medications. The risk of side effects is greater when other medical conditions are present; of particular concern are:

• Any cardiovascular conditions, such as heart rhythm disorders or heart disease
• Any history of heart attack or stroke
• Kidney disorders
• High risk factors for the above, including family history of cardiovascular issues, obesity, smoking, and so forth

The above conditions do not necessarily mean Catapres cannot be used, but risks and warning signs should be discussed carefully with a doctor before starting treatment.

Likewise a number of medications can cause complications if used with Catapres; double-check with a doctor or pharmacist about safety if taking:

• Medications that induce drowsiness
• Any antipsychotic or antidepressant medications
• Any medications that influence blood pressure
• Any medications that influence heart beat

If Catapres has been used for more than a few weeks treatment should not stop abruptly; there is a risk of cardiovascular complications due to the medication's effect on blood pressure. Dosage should be gradually reduced over several weeks.

Catapres can cause mild to moderate drowsiness; exercise caution until effects are known.