Quick Facts
Generic NameClonidine
Brand NameCatapres
Drug ClassAlpha-2 Agonist
FDA Approved1974
Starting Dose0.1mg at bedtime
Typical Range0.1–0.4mg/day
Max Dose0.6mg/day
Half-Life12–16 hours
MetabolismHepatic (50%), renal (50%)
Generic Available1986
What Is Catapres?
Clonidine (brand name Catapres) is a central alpha-2 adrenergic agonist (Alpha-2 Agonist) prescribed for ptsd nightmares/hyperarousal, adhd, opioid/alcohol withdrawal, and other psychiatric conditions. Versatile off-label psychiatric uses: PTSD nightmares, ADHD adjunct, withdrawal management, acute agitation. Extended-release (Kapvay) FDA-approved for pediatric ADHD. Transdermal patch available. Very inexpensive. MUST NOT stop abruptly — rebound hypertension. Also used for Tourette's tics.
At Psychiatry Telemed, clonidine is prescribed and monitored by board-certified psychiatrists who understand the nuances of Alpha-2 Agonist pharmacology — selecting the right dose, managing side effects, monitoring drug interactions, and optimizing your treatment through consistent monthly medication management appointments.
Clonidine (Catapres) — Alpha-2 Agonist medication for psychiatric care
ManufacturerVarious (originally Boehringer)
How Catapres Affects Neurotransmitters
How Catapres Works
Clonidine stimulates alpha-2 adrenergic receptors in the brainstem, reducing sympathetic outflow from the central nervous system. This decreases norepinephrine release, producing sedation, reduced blood pressure, and attenuation of the hyperadrenergic state seen in PTSD, anxiety, and substance withdrawal.
Efficacy: Catapres vs. Comparators
Efficacy Comparison
Response & remission rates vs. comparators (Cipriani et al. meta-analysis)
Data from published meta-analyses. Individual response may vary.
Conditions Treated with Catapres
PTSD Nightmares/Hyperarousal
Off-label for PTSD-related nightmares, hyperarousal, and sleep disruption.
Learn About PTSD Nightmares/HyperarousalOpioid/Alcohol Withdrawal
Off-label for managing withdrawal symptoms — reduces sympathetic hyperactivity.
Learn About Opioid/Alcohol WithdrawalConsidering Catapres?
Board-certified psychiatrists can determine if clonidine is right for you.
Dosage Information
| Indication | Starting Dose | Typical Range | Maximum |
|---|---|---|---|
| PTSD Nightmares/Hyperarousal | 0.1mg at bedtime | 0.1–0.4mg/day | 0.6mg/day |
| ADHD | 0.1mg at bedtime | 0.1–0.4mg/day | 0.6mg/day |
| Opioid/Alcohol Withdrawal | 0.1mg at bedtime | 0.1–0.4mg/day | 0.6mg/day |
| Anxiety/Agitation | 0.1mg at bedtime | 0.1–0.4mg/day | 0.6mg/day |
Brain Regions Targeted by Catapres
Side Effects
Like all medications, clonidine has potential side effects. Most are mild, occur early in treatment, and resolve within 1–2 weeks. Your psychiatrist monitors at every appointment.
Common Side Effects
Drowsiness/SedationDry MouthDizzinessConstipationHypotensionBradycardia
Less Common
HeadacheFatigueNauseaInsomnia (rebound)Irritability
Serious (Seek Immediate Help)
Rebound Hypertension (abrupt discontinuation)Severe BradycardiaAV BlockWithdrawal Syndrome
Side Effect Profile: Catapres vs. Class Average
Side Effect Profile
Incidence rates from FDA prescribing information vs. class average
Percentages from clinical trial data. Actual experience may differ.
⚠️ FDA Black Box Warning
No psychiatric-specific black box warning. REBOUND HYPERTENSION if stopped abruptly — taper over 2–4 days.
Drug Interactions
Major Interactions
CNS depressants (additive), antihypertensives (additive), beta-blockers (rebound hypertension risk if clonidine stopped)
CYP Metabolism
50% hepatic metabolism (not CYP-specific), 50% renal excretion. Few significant CYP drug interactions.
Alcohol
Avoid alcohol during clonidine treatment. Both affect the CNS, increasing sedation and impairing judgment.
Generic Versions & Cost
Generic clonidine available since 1986. Approximate cost: $4/month. FDA-certified bioequivalent to brand-name Catapres.
Starting Catapres: What to Expect
First Weeks
Clonidine is typically started at 0.1mg at bedtime and increased gradually. Common initial side effects usually improve within 1–2 weeks. Full therapeutic benefit develops over 4–8 weeks.
When to Contact Your Psychiatrist
Contact your psychiatrist for: worsening depression/anxiety, thoughts of self-harm, unusual agitation, severe side effects, or any concerning changes.
Stopping Catapres Safely
Never stop clonidine abruptly. Your psychiatrist will develop a gradual tapering schedule to minimize discontinuation effects.
Timeline: When Catapres Starts Working
Timeline to Effectiveness
Expected improvement trajectory over the first 8 weeks
Based on clinical trial data. Full therapeutic effects may take 6–8 weeks.
Get Catapres from a Board-Certified Psychiatrist
At Psychiatry Telemed, clonidine is prescribed following comprehensive evaluation. All Florida via HIPAA-compliant telepsychiatry. 1–3 days. $200 eval, $100 follow-up.
Frequently Asked Questions
Prescribed for ptsd nightmares/hyperarousal, adhd, opioid/alcohol withdrawal, anxiety/agitation.
Typically 2–4 weeks for initial improvement, 4–8 weeks for full benefit.
Common: drowsiness/sedation, dry mouth, dizziness, constipation, hypotension. Most resolve within 1–2 weeks.
No. Not habit-forming but should not be stopped abruptly — gradual tapering recommended.
Versatile off-label psychiatric uses: PTSD nightmares, ADHD adjunct, withdrawal management, acute agitation. Extended-release (Kapvay) FDA-approved for pediatric ADHD. Transdermal patch available. Ver
Alcohol should be avoided — increases sedation, impairs judgment, and may worsen symptoms.
Resources
Medical Disclaimer: Educational only. Consult a psychiatrist before starting/stopping medication. Crisis: call 988 or 911.
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