Clonidine during treatment of opiate withdrawal. A concluding overview

An overview is presented about the research in the National Institute for Public Health and Environmental Protection, which was carried out during the last 10 years with respect to the pharmacological background of the use of clonidine in the detoxification of opiate-dependent patients. At first the question was: In which way and on which site does clonidine act? The way in which clonidine exerts its action was made clear, viz. stimulation of the alfa2 adrenoceptor. Both the inhibitory and the excitatory action with respect to different symptoms were mediated by this receptor. Secondly, the research was directed to the question whether clonidine would suppress more than only symptoms related to a sympathetic hyperactivity, especially whether behavioural symptoms would be sensitive to clonidine. It has to be concluded that the use of clonidine in the detoxification of opiate-dependent people is based mainly on the suppression of the sympathetic hyperactivity. Symptoms with a more behavioural character appeared to be less sensitive to clonidine. Such a difference in sensitivity between these two types of symptoms now known to occur also clinically. Therefore, the present data confirm the clinical picture.HI