Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder characterized by poor attention span, impulsivity, and hyperactivity (Reference 3). ADHD is usually treated with stimulant medication, such as Ritalin or Adderall. However, stimulants have many side effects and can be intolerable or ineffective in some patients. Alternatives or additions to stimulant treatment include antidepressants, benzodiazepenes and antihypertensives. Antihypertensives, including clonidine, guanfacine and propranolol, are most commonly used to treat high blood pressure but also help with ADHD. Antihypertensives may be more effective in children with ADHD than adults with the disorder, as little clinical data showing improvement has been reported in adults (Reference 1).
Clonidine
Clonidine is marketed as Catapres. Clonidine is used to treat ADHD, aggression, Tourette's syndrome and sleep disruption (Reference 2). Common side effects include irritability, depression, sedation, and low blood pressure (Reference 2). Clonidine may work by inhibiting norepinephrine release from the locus ceruleus, a brain region associated with controlling aggressive behaviors (Reference 5). Clonidine works best for ADHD patients that are overaroused, impulsive and aggressive, as opposed to hyperactive and innattentive, according to a study by Hunt and others in 1991 (Reference 4).
Guanfacine
Guanfacine is a more selective beta-adrenergic agonist than clonidine. Guanfacine is marketed under the brand name Tenex. Guanfacine is used to treat ADHD and Tourette's syndrome (Reference 2). Common side effects include irritability and tiredness (Reference 2). One study by Hunt and others in 1995 found that hyperactivity and attention symptoms in juvenile ADHD patients were helped by guanfacine (Reference 4).
Propranolol
Propranolol is sold under the brand name Inderal. Pronanolol is taken either once a day in the extended release form or 2 to 4 times a day. Common side effects include vomiting, nausea, constipation, diarrhea, dizziness, depression and lucid dreams (Reference 2). Very high doses of propanolol can lead to slowing of the heart, problems breathing and low blood pressure (Reference 2). One small study by Mattes and others in 1986 found that high doses of propranolol were 85% effective in reducing ADHD symptoms and temper outbursts in ADHD patients with anger issues (Reference 1).
References
- "Clinicians' Guide to Adult ADHD: Assessment and Intervention," Sam Goldstein and Anne Teeter Ellison; 2002
- "Mental Health Medications for Children: A Primer," Ronald T. Brown, Laura Arnstein Carpenter, and Emily Simerly; 20055
- The Merck Manual
- "Annual Progress in Child Psychiatry and Child Development 1997," Margaret E. Hertzig; 1997
- "Interventions for ADHD: Treatment in Developmental Context," Phyllis Anne Teeter; 1998
