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Sara PA & Shari
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<blockquote data-quote="Sara PA" data-source="post: 158804" data-attributes="member: 1498"><p>If you want to read the prescribing information for clonidine, google "Catapres prescribing information". The listed post-marketing side effects include</p><p></p><p><em>Central and Peripheral Nervous System/Psychiatric: Delirium; mental depression; visual and auditory hallucinations; localized numbness; vivid dreams or nightmares; restlessness; anxiety; agitation; irritability; other behavioral changes; and drowsiness</em> </p><p></p><p>Post marketing adverse reactions are those that doctors and others report after the drug is approved for sale. Though the prescribing information says that none of these side effects have occurred in more than 0.5&#37; of the people taking it, keep in mind that it is estimated that <em>at best</em> 1-in-10 adverse reactions are reported. It is widely believed that fewer than 1-in-100 are reported. </p><p></p><p>Way back in 1997 at the Second International Conference on Bipolar, this was presented</p><p></p><p><em>Guanfacine (Tenex) and Juvenile Bipolar Illness</em></p><p><em></em></p><p><em>Authors: J.P. Horrigan, M.D. and L.J. Barnhill, M.D.</em></p><p><em></em></p><p><em>Guanfacine hydrochloride (Tenex) is an alpha-2 adrenergic agonist which has received recent attention in the field of child and adolescent psychiatry due to its apparent benefits in managing attention-deficit/ hyperactivity disorder (ADHD), tic disorders, and posttraumatic stress disorder. The initial reports noted minimal side effects. This poster details six cases of adverse responses to guanfacine, drawn from an initial clinic sample of 95 outpatient boys and girls aged 8 to 15 years who were seen in a university-based developmental neuropsychiatric clinic. In each case, the patient met formal DSM-IV criteria for ADHD while four out of six also met criteria for Tourette's Disorder. Within 72 hours of initiation of guanfacine therapy, drastic changes in mood and behavior occurred in each of these individuals, culminating in states that resembled hypomania and mania, including elevated mood, poor sleep hygiene, and hypersexuality. The dose of guanfacine ranged from l to 2 mg/day. Later investigation revealed that all of the youngsters had clinical and/or familial risk factors for bipolar disorder. The authors speculate about the possible mechanisms behind these side effects, and suggest that bipolar disorder may be a relative contraindication to guanfacine therapy.</em></p><p></p><p>For a while that information was included on the Tenex prescribing information. Unfortunately I haven't been able to find the prescribing information for either Tenex or any of the generics for a number of years.</p><p></p><p>To the best of my knowledge about antihypertensives, pretty much all of them can cause depression. Every one I ever check did but there are a lot of antihypertensives out there, I could be overstating the situation. </p><p></p><p>The Trileptal is still quite a low dose and may not be particularly effective.</p></blockquote><p></p>
[QUOTE="Sara PA, post: 158804, member: 1498"] If you want to read the prescribing information for clonidine, google "Catapres prescribing information". The listed post-marketing side effects include [I]Central and Peripheral Nervous System/Psychiatric: Delirium; mental depression; visual and auditory hallucinations; localized numbness; vivid dreams or nightmares; restlessness; anxiety; agitation; irritability; other behavioral changes; and drowsiness[/I] Post marketing adverse reactions are those that doctors and others report after the drug is approved for sale. Though the prescribing information says that none of these side effects have occurred in more than 0.5% of the people taking it, keep in mind that it is estimated that [I]at best[/I] 1-in-10 adverse reactions are reported. It is widely believed that fewer than 1-in-100 are reported. Way back in 1997 at the Second International Conference on Bipolar, this was presented [I]Guanfacine (Tenex) and Juvenile Bipolar Illness Authors: J.P. Horrigan, M.D. and L.J. Barnhill, M.D. Guanfacine hydrochloride (Tenex) is an alpha-2 adrenergic agonist which has received recent attention in the field of child and adolescent psychiatry due to its apparent benefits in managing attention-deficit/ hyperactivity disorder (ADHD), tic disorders, and posttraumatic stress disorder. The initial reports noted minimal side effects. This poster details six cases of adverse responses to guanfacine, drawn from an initial clinic sample of 95 outpatient boys and girls aged 8 to 15 years who were seen in a university-based developmental neuropsychiatric clinic. In each case, the patient met formal DSM-IV criteria for ADHD while four out of six also met criteria for Tourette's Disorder. Within 72 hours of initiation of guanfacine therapy, drastic changes in mood and behavior occurred in each of these individuals, culminating in states that resembled hypomania and mania, including elevated mood, poor sleep hygiene, and hypersexuality. The dose of guanfacine ranged from l to 2 mg/day. Later investigation revealed that all of the youngsters had clinical and/or familial risk factors for bipolar disorder. The authors speculate about the possible mechanisms behind these side effects, and suggest that bipolar disorder may be a relative contraindication to guanfacine therapy.[/I] For a while that information was included on the Tenex prescribing information. Unfortunately I haven't been able to find the prescribing information for either Tenex or any of the generics for a number of years. To the best of my knowledge about antihypertensives, pretty much all of them can cause depression. Every one I ever check did but there are a lot of antihypertensives out there, I could be overstating the situation. The Trileptal is still quite a low dose and may not be particularly effective. [/QUOTE]
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