I’ll admit it. The medication that first struck fear into my heart when the psychiatrist advised it was a blood pressure medication called Clonidine. It was early in our journey of working with our psychiatrist. And I was terrified and feeling very guilty that I had acquiesced to medicating my 6-year-old. Messing with her blood pressure sounded very dangerous to me.

I have since learned that the use of these hypertensive medications to control impulsivity is rather commonplace and definitely not the most risky move that a doctor can make when treating our complicated children. The dosage is much lower than what is prescribed to treat high blood pressure...and in many cases our children's blood pressure may be on the slightly elevated side already.

There are two hypertensive medications commonly prescribed to control impulsivity:

Catapres – generically called clonidine
Tenex – generically called guanfacine

These medications have the side effect of drowsiness and lowering blood pressure…which may be a good thing. Sometimes they are prescribed to help with sleeping problems. They are slower reacting than stimulant meds or Strattera…meaning that the child has to slowly build up to the recommended dosage and that it make take -3 weeks or more to know how effective using this medication will be.

The same is true for taking the child off this medication. You shouldn’t just stop giving them these meds…the dose must be slowly decreased.

These medications have also been shown to reduce tics, especially motor tics in those people with tic disorders or Tourettes Syndrome.

Many people who have Tourettes Syndrome also have ADHD or symptoms of ADHD. (Many also have OCD and the combination of the three conditions is often referred to as Tourettes Plus.)

Stimulant medications, while helping with the ADHD symptoms, can aggravate the tics – it is estimated that about 30-40% of those with Tourettes actually get a worsening of their tics with Ritalin. Clonidine and guanfacine seem to work much better as a first-line defense to reduce impulsivity and hyperactivity in the children who have both.

ADDMD: Clonidine

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