ADHD and Antihypertensives

Antihypertensives were originally used to reduce high blood pressure. However they have since been shown to reduce the symptoms of excessive hyperactivity and impulsivity in children with ADHD. The two most commonly used in the treatment of ADHD are clonidine and guanfacine.

Antihypertensives selectively stimulate the receptors associated with the neurotransmitters norepinephrine and epinephrine in the brain. The result is an increase in an individual’s ability to concentrate.

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Clonidine and guanfacine have been shown to reduce the symptoms of hyperactivity, impulsivity and aggression in people with ADHD. Both drugs have also been used for individuals suffering from tic disorder. Finally, some practitioners will prescribe antihypertensives to individuals with ADHD as a sedative.

Sold under the brand name Catapres, clonidine can be administered orally or as a skin patch. Gluanfacine is sold under the brand names Tenex (regular formula) and Intuniv (extended-release formula) and is typically taken once a day around bedtime. Dosages include .05 to .4 mg for clonidine and .5 to 3 mg for guanfacine.¹ Many physicians will request a baseline electrocardiogram in addition to monitoring a patient’s vital signs during treatment.

Medical practitioners and psychiatrists

All antihypertensives are associated with a number of serious side effects. Sedation is the most common. Antihypertensives can also be associated with rapid heartbeat resulting from a skipped dose or fast withdrawal. Other side effects include the following:

• Dry mouth;
• Fatigue;
• Headaches;
• Weakness;
• Depression;
• Decreased sexual ability;
• Decreased appetite;
• Nervousness;
• Stomach pain;
• Nausea;
• Vomiting; and
• Constipation.

Like clonidine and gluanfacine, beta blockers were originally introduced to lower blood pressure and improve heart function. More recently, however, psychiatrists have adopted them for the treatment of ADHD. Beta blockers have effectively reduced the symptoms of anxiety, tantrums and rage and have been shown to treat chronic aggression and impulsivity in individuals with ADHD.² The different types include propranolol, nadolol and atenolol.

1. Thomas E. Brown, Ph.D., Attention Deficit Disorder: The Unfocused Mind in Children and Adults, (New Haven and London: Yale University Press, 2005): 269.
2. Edward M. Hallowell, M.D., and John J. Ratey, M.D. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. (New York: Ballantine Books, 2005), 257.