Clonidine: the blood pressure drug that can prevent PTSD

In line with the recent trend of repurposing drugs for other illnesses, clonidine seems to be the latest surprise on the list. Researchers have found that clonidine, a drug used for high blood pressure and ADHD, can be very effective in preventing PTSD symptoms.

Post-traumatic stress disorder is a pretty agonizing mental illness and can get life-threatening. When you think about the torturous memories patients have to go through whenever they get into a similar situation or place where the trauma originally took place, it's not hard to see why.

For example, someone suffering PTSD from war may relive the pain whenever they hear gunshots or see a war movie. If the PTSD resulted from a car crash, the symptoms may be triggered whenever the person gets into a car or sees one speeding towards them. That's because their brain has associated that memory of fear with the sight, site, or sound. So they have to relive the fear whenever they see the place or get into a similar situation.

But you know what? There's an axis in the brain responsible for consolidating and storing these fear memories, and that's where clonidine comes in.

Clonidine and how it prevents PTSD development

There's a novel axis in the hippocampus of the brain, responsible for maintaining fear memories. In this axis, there are spines (ends of a neuron) where information is exchanged. When there's stimulation, whether good or bad, the spines store the information and get bigger, forming mushroom shapes.

But for the spines to store information and increase in size, a protein known as cofilin must exit. Clonidine, the blood pressure drug, prevents the exit of cofilin, thereby preventing the storage of fearful memories, and consequently stopping the development of PTSD.

Isn't that interesting? That a medication designed for reducing high blood pressure would be key to preventing or managing PTSD.

In essence, when someone who just suffered a traumatic experience takes clonidine, their brain may be unable to retain that fearful memory. So the event would no longer be associated with similar future situations, and the person won't have to relive the same experience repeatedly.

A second look at clonidine in PTSD

Interestingly, this isn't the first time clonidine would be studied for use in PTSD. There has long been the hypothesis that since clonidine works on brain receptors that are activated in PTSD, the high blood pressure medication may also have an effect on PTSD. But it didn't really work out as the scientists imagined.

Clonidine has a sister drug known as guanfacine. Both drugs activate the same receptors. So, both should be effective in PTSD, right? Wrong! Clinical trials showed that guanfacine offered no benefit to PTSD patients. So they discarded the whole idea of clonidine for PTSD.

But now, they took a fresh new look at clonidine. That's because although clonidine and guanfacine bind to the same receptor in the brain, they do different things there.

For now, studies have been conducted on mice to see how clonidine really works. So far, the results are amazing and promising.

Clonidine for PTSD is not a way to erase the traumatic memory; instead, it makes the memory less strong and impactful. So when you get into a similar situation like when the trauma first happened, the spines that hold that information become unstable as they were unable to consolidate the memory. Before the memory stabilizes, the strength of the bad memory would have at least diminished.

More on the research here.

There's a whole lot of promise here for people who are just now coming from a traumatic situation, such as the pandemic, or a war. More studies would be required, but the good news is, there's hope!

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.