title: Tolerability profile of clonidine in the treatment of adults with Tourette syndrome.
abstract: OBJECTIVE
  Clonidine, an alpha-2 adrenergic agonist, has been used to treat Tourette syndrome (TS) for nearly 3 decades. This first-tier medication is especially recommended for children and adolescents with a combination of attention-deficit/hyperactivity disorder and mild tics. Although clonidine is thought to have a low rate of adverse effects (AEs), little is known about its tolerability profile in adult patients with TS.
  
  
  METHODS
  This study investigated the prevalence and characteristics of AEs associated with clonidine through a retrospective chart review. We assessed 36 patients with TS (27 men; mean [SD] age, 24.6 ± 13.9; range, 10-62 years), of whom 32 (88.8%) had comorbid conditions (most common: attention-deficit/hyperactivity disorder, n = 12; obsessive-compulsive disorder, n = 9).
  
  
  RESULTS
  Seventeen patients (47.2%) experienced AEs. Eleven patients (30.5%) withdrew clonidine because of the severity of AE (n = 5) or absence (n = 4)/reduction (n = 2) in efficacy. The most commonly reported AEs were sedation and headache. In most cases, AEs were mild and occurred with higher starting doses. In 12 patients (70.6%) who also took other psychotropic medications, cotherapy could have been linked to the appearance of AE.
  
  
  CONCLUSIONS
  Our findings suggest that clonidine is a safe and well-tolerated medication in the TS population. Adults with TS treated with this medication experience mild and relatively infrequent AE; high starting dose and polytherapy seem to be the only clinically relevant risk factors for AE development.
authors.affiliation: The Michael Trimble Neuropsychiatry Research Group, BSMHFT and University of Birmingham, UK. a.cavanna@ion.ucl.ac.uk
authors.forename: Andrea Eugenio
authors.initials: AE
authors.lastname: Cavanna
authors.forename: Claudia
authors.initials: C
authors.lastname: Selvini
authors.forename: Cristiano
authors.initials: C
authors.lastname: Termine
authors.forename: Umberto
authors.initials: U
authors.lastname: Balottin
authors.forename: Clare M
authors.initials: CM
authors.lastname: Eddy
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D002648:Child; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D005879:Tourette Syndrome / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D006993:Hypnotics and Sedatives; D003000:Clonidine