Clonidine for Anxiety: Uses, Side Effects, & More

What Is Clonidine (Catapres)?

Clonidine, also called by its brand names Catapres and Kapvay, is a medication that is FDA approved for blood pressure control, but it is also used for ADHD symptoms when it is the extended-release formulation.^1,2 It belongs to a class of medications called alpha 2 adrenergic agonists, which acts centrally on the body, resulting in the relaxation of arteries. This medication promotes relaxation and reduction in hyperactivity which is beneficial for those with ADHD.

How Effective is Clonidine for Anxiety?

There are limited studies proving the effectiveness of clonidine in anxiety, but there are a few that suggest there are some benefits in controlling anxiety symptoms with the medication. One study saw a greater decrease in anxiety at one hour in patients with panic disorders, and in the second study, it was noted that some patients saw benefit but that was not seen within the entire study group.⁴ Another study observed 23 patients and saw a decrease in anxiety attacks.⁵

How Does Clonidine Help Anxiety?

Clonidine is an off-label medication for anxiety, meaning that a medication is used for a purpose that has been studied but has not been through the FDA approval process. Clonidine has been used for conditions involving too much arousal of the nervous system, like PTSD. These effects also make Clonidine helpful as an anxiety treatment. Clonidine helps people feel more relaxed and calms them down by lowering their blood pressure. This is beneficial as anxiety is associated with increased activity in the nervous system and elevated blood pressure.

Clonidine for Performance Anxiety

While it’s not entirely understood how Clonidine helps symptoms of performance anxiety, it can be used as a treatment and may benefit some who use it for this reason.

Clonidine for Panic Attacks

Clonidine may be able to help with panic disorders. Clonidine impacts the levels of hormones and neurotransmitters associated with panic attacks, potentially reducing and relieving symptoms. as it controls your blood pressure, something that typically rises when an individual is stressed.⁶ The added focus and calmness may help to control the worst effects of the panic attack.

Clonidine for Social Anxiety Disorder

Similar to performance anxiety, social anxiety disorder could be treated with clonidine. The reason for Clonidine’s helpful effect on social anxiety symptoms is not understood, but it may be a beneficial treatment for some individuals.⁷

Clonidine Side Effects

As with all medications, there is a potential for side effects. In particular, clonidine’s common side effects are associated with its main action of lowering blood pressure. Not all side effects may occur, but if they do, they may require medical attention. In particular, it is a concern if clonidine causes an allergic reaction like those listed below in severe side effects.

Common clonidine side effects include:^1,2,3

• Tiredness
• Dizziness
• Constipation
• Low blood pressure
• Headache
• Dry mouth

Severe side effects that require immediate medical attention include:^1,2,3

• Rash
• Hives
• Swelling of the face, throat, tongue, lips, eyes, lower legs, etc.
• Difficulty swallowing or breathing

Most side effects associated with Clonidine are mild and tend to go away with continued therapy. Commonly, you will experience side effects like dizziness, tiredness, and constipation when you first start the medication. Check with a healthcare professional if you continue to experience any side effects or if they become bothersome. Seek immediate medical help in the event of a severe reaction.

Drug Interactions With Clonidine

Clonidine, as with most medications, has the potential to have a drug interaction with other substances. This is when the two substances interact to cause an undesired effect which can range from a minor to a severe reaction.

Medications that can negatively interact with clonidine include:²

• Antipsychotics: When taken together, it may cause issues with dizziness, fatigue, and blood pressure issues when you go from sitting to standing.
• Beta-blockers: Both clonidine and medications within the beta-blocker class work to lower blood pressure. Together, they may cause a significant lowering of blood pressure.
• Alcohol: Both clonidine and alcohol suppress the central nervous system in their own ways, potentially causing more fatigue or sedation when combined.

Disclaimer: Taking certain medications, herbs, or supplements alongside clonidine can change how clonidine works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Can You Overdose on Clonidine?

Overdoses can occur when you take too much clonidine. If you suspect you have taken more than prescribed, then contact poison control (1-800-222-1222) or call 911 immediately. You should seek immediate medical care, especially if you display symptoms of an overdose.

Clonidine overdose symptoms include:^1,2,3

• Fainting
• Shivering
• Slurred speech
• Slow heart rate
• Confusion
• Drowsiness
• Weakness
• Cold, pale skin
• Difficulty breathing
• Pinpoint pupils

How to Get a Prescription for Clonidine

Clonidine can be obtained by being prescribed by a medical provider who is authorized to write prescriptions. This medication is not one that is typically considered for anxiety symptoms, so most doctors or psychiatrists, both in-person or online psychiatry services, will have you try the more common treatments before trying clonidine.

Alternative Treatments for Anxiety

There are many avenues of anxiety treatment that can be done for anxiety through both medication as well as non-medication routes. Some common treatments for anxiety include the use of antidepressants, anti-anxiety medications, and other blood pressure medications.⁸ Antidepressant medications like serotonin-selective reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are effective medications that can help manage anxiety symptoms long term.

Anti-anxiety medications commonly used belong to a class called benzodiazepines and they are used commonly to treat anxiety and panic attacks. They are meant to be used during bouts of anxiety and are not preventative medications, as they typically have a short window of action. It is also important to note that these medications have the potential for a person to develop a dependence or addiction to them. They should be taken as prescribed to lessen the chance that this occurs.

Non-medication measures that can be taken to help with anxiety involve strategies to manage your stress as well as your triggers. A lifestyle change that some people with anxiety disorders may help would include joining a support group as well as stress management techniques, like exercise and meditation. Cognitive behavioral therapy (CBT) is a therapeutic treatment often recommended alongside medication for several mental health conditions. Specifically, CBT for anxiety uses techniques targeted at managing anxiety symptoms. Consider talking to your doctor for recommendations that may fit your needs.

Questions to Ask Your Healthcare Provider About Clonidine for Anxiety

If you are considering taking clonidine or are already on it for anxiety, then you should consider talking to your doctor, psychiatrist, or pharmacist about your expectations while on this therapy. You should ask questions like what side effects you should expect, how you know this medication is helping with your anxiety, and when to ask for help from medical professionals.

Questions to ask your care team when considering the side effects of clonidine may include:

• Can I use clonidine along with therapy to treat anxiety?
• How long will it take for me to adjust to taking clonidine?
• Am I at risk for more severe symptoms if I am already taking other anxiety /depression medications?
• What is the best dosage to ensure fewer side effects?
• Are there drugs I am taking that could have negative interactions?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• What are some signs that this medication is not helping with my anxiety?
• Does this medication lower my blood pressure too much in combination with any other medications I take?
• I’m getting dizzy while on this medication; how long does that last?

In My Experience

In my experience, clonidine isn’t used much for anxiety. This medication is typically used for managing high blood pressure and sometimes ADHD symptoms. There could be potential for the use of clonidine in anxiety, although the other methods described earlier in the article are what you typically try first, as they have more studies showing how effective they are for anxiety.

That being said, each person’s therapy is different, and what works for one person may not work for you. It is important to talk to your doctor about your anxiety and if you think you need a change in therapy to manage your symptoms better. You should follow your doctor’s guidance to avoid any unintended side effects or problems.

For Further Reading

• Stage Fright: Definition, Causes, & How to Get Over It
• Mirtazapine for Anxiety: All You Need to Know
• Options for Anxiety Therapy
• Anxiety Attack vs Panic Attack
• Anxiety and Depression Association of America Resources
• Anxiety Disorders