Is clonidine a controlled substance?

In this article:

• Is clonidine a controlled substance?
• What can I take instead of clonidine?
• Clonidine alternatives

In this article

• Is clonidine a controlled substance?
• What can I take instead of clonidine?
• Clonidine alternatives

According to estimates from the American Heart Association (AHA), around half of the U.S. adult population has high blood pressure (hypertension). Most of these individuals remain unaware of their condition. The good news is that certain prescription medications can help—including clonidine. Known by the brand name Catapres, clonidine is an antihypertensive drug that lowers blood pressure by dilating and relaxing blood vessels. Additionally, the U.S. Food and Drug Administration (FDA) has approved Catapres for treating Attention Deficit Hyperactivity Disorder (ADHD) and managing tics related to Tourette’s Syndrome.

Some ADHD medications are controlled substances. Most blood pressure drugs are not. So, where does clonidine fall? 

Is clonidine a controlled substance?

“Clonidine is not classified as a controlled substance due to its low potential for abuse compared to other medications,” says Dr. Andrew Youssouf, Addiction Medicine physician and the medical director of Ikon Recovery. According to the U.S. Controlled Substances Act, the Drug Enforcement Administration (DEA) can classify a drug as controlled based on “the substance’s medical use, potential for abuse, and safety or dependence liability.” Clonidine has little to no risk of addiction and a low potential for overdose. Therefore, clonidine is not classified as a narcotic and does not fall on the DEA’s schedule for controlled substances. 

“That being said, it can still be misused for its sedative properties, especially when combined with opioids, benzodiazepines, or alcohol,” Dr. Youssouf says. It can amplify the effects of alcohol consumption, illicit drugs, and other central nervous system depressants. That’s why individuals looking to extend their “high” may take it, according to the American Addiction Centers, but it could cause serious side effects that require medical attention. In extreme cases, clonidine abuse may cause loss of consciousness, stroke, seizures, heart failure, heart attacks, respiratory depression, coma, or even death.

“When taken in excess or with other substances, clonidine may cause extreme tiredness, depression, cardiac system complications, disruption, digestive issues, severe allergic reactions, and hallucinations,” says Dr. Lea McMahon, LPC, EdD, the chief clinical officer at Symetria Recovery. However, “some of these side effects may also be experienced with clonidine alone, which is why a patient should only consume it under the close supervision of a trusted and knowledgeable physician.” 

Anyone taking central nervous system (CNS) depressants like antihistamines, allergy or cold medications, sedatives, tranquilizers, sleeping medicine, prescription pain medications, barbiturates, seizure medications, or muscle relaxants should tell their healthcare provider and pharmacist before taking clonidine. Their physician may look for other options that don’t present the same risks or adjust the dosage. 

Sometimes, a healthcare provider might use clonidine as a detox method to help ease withdrawal symptoms, says Dr. McMahon. But “this should only be an explored remedy under the monitored care of a healthcare professional due to the sensitive nature of recovery itself, and the serious issues in motion that patients encounter while on their journey of sobriety.”

Clonidine side effects

On its own, clonidine use poses few serious risks. Still, it’s important to know the potential adverse effects it may cause. According to clinical trial results from the drug’s prescription label, the most common side effects of clonidine include:

• Dry mouth
• Drowsiness
• Dizziness
• Constipation
• Sedation

There are also rare reports of other side effects, including:

• Fatigue
• Fever
• Headache
• Weakness
• Heart problems, including irregular heartbeat conditions, congestive heart failure, and palpitations
• Mental health effects include agitation, anxiety, delirium, delusions, hallucinations, insomnia, mental depression, and sleep disorders.
• Skin conditions like alopecia, hives, and rash
• Gastrointestinal issues, including abdominal pain, nausea, and vomiting
• Sexual dysfunction
• Elevated blood sugar
• Weight gain
• Muscle or joint pain
• Nasal dryness
• Blurred vision
• Dry eyes
• Runny nose

What can I take instead of clonidine?

Whether you think the risk of side effects and possible drug interactions outweigh clonidine’s potential benefits or the doctor determines it’s just not a good fit, there are several alternatives. 

For blood pressure problems, other antihypertensive drugs are typically safe, and none are classified as controlled substances. They each have potential side effects, interactions, and precautions. Therefore, consulting with a healthcare professional to determine the most suitable treatment for your specific condition is essential. Some common alternative treatment options include:

• Diuretics: A common first-line treatment of hypertension, diuretics (water pills) help the body eliminate excess fluid and salt, decreasing blood pressure.

• Alpha agonists: Drugs in this class of medications mimic norepinephrine, inhibiting the release of certain neurotransmitters and decreasing sympathetic nervous system activity. Clonidine is an alpha-2 agonist. 

• • Angiotensin receptor blockers (ARBs): Also known as angiotensin receptor II antagonists, these medications block receptor proteins that restrict blood vessels, thereby relaxing the vessels and lowering blood pressure.

• ACE inhibitors: Prescription drugs in this class reduce an enzyme responsible for narrowing blood vessels, which lowers blood pressure. 

• Calcium channel blockers: These antihypertensives stop calcium from getting into the heart and arteries, which relaxes them. 
• Beta blockers: This medication class blocks the release of ​​adrenaline and noradrenaline, causing the heart to beat with less force. 

Alternative treatment for the symptoms of attention deficit hyperactivity disorder, however, gets a little more complicated. That’s because some ADHD drugs are in a class of medications called stimulants, and all stimulants are controlled substances since they have a high potential for addiction. Here are a few of the most common options:

• Adderall: Perhaps the most well-known ADHD medication, Adderall is an amphetamine and a Schedule II controlled substance. It has been proven effective for children and adults, but the DEA considers it addictive, and it may cause withdrawal symptoms after treatment stops. 

• Ritalin: Like Adderall, Ritalin is a stimulant and a Schedule II controlled substance. One meta-study suggests it’s better for children, while Adderall is a more common choice for adults. But like Adderall, it comes with the risk of dependence and developing substance use disorder. 

• Focalin: Focalin has a different active ingredient than Adderall, and research has proven it effective for ADHD treatment. However, it’s also a controlled substance and poses the risk of addiction and abuse. 

• Vyvanse: Like Adderall and Ritalin, Vyvanse is a stimulant, but some studies say it has a lower risk of abuse. 

• Strattera: This is a selective norepinephrine reuptake inhibitor (SNRI), so it’s not a stimulant or a controlled substance. However, in studies, it has still shown effectiveness in treating ADHD, making it a potentially safer option. 

• Qelbree: As a selective norepinephrine reuptake inhibitor (SNRI), Qelbree isn’t a controlled substance, and like Strattera, it’s effective in treating ADHD symptoms without the risk of addiction.
• Tenex (guanfacine): Like clonidine, Tenex is a treatment for high blood pressure and ADHD, and it’s not a controlled substance.

Here’s a list of common clonidine alternatives:

While clonidine has demonstrated efficacy in managing various conditions, it may not be right for everyone. It is essential to consult with a healthcare professional to determine the most appropriate treatment plan for your condition.