ADHD in Children Q&A by Dr. Phillips
Your question raises a very common concern amongst both doctors and patients (and in pediatrics, the parents of the patients!). When drug companies develop new medications, it is very common that their research and development and subsequent clinical testing does not involve children. One would have to ask the companies why this is so, but it is a reality. And so when these drugs are released for use, the drug companies are forced to state that "Safety and effectiveness in pediatric patients below the age of 12 have not been established" when they describe the drug in their formal product descriptions (most readily found by doctors and laymen alike in the Physicians Desk Reference [PDR]). Notice that this statement does not prohibit the drug's prescription to patients under age 12. But it leaves physicians and patients quite anxious.
Clonidine is such a medication. Once these types of medications are released, they are very frequently wonderful and very effective medications within the pediatric age group. But very often, their use is first applied to the pediatric-age patients in teaching hospitals and learning centers, effectively doing the "testing" at this level. Appropriate adjustments in dosages are made and the effects (and side effects) observed and the results published within the pediatric literature. As a private-practice pediatrician myself, it is only after such data is well-established that I feel comfortable enough to prescribe such a drug.
In reality, clonidine is now a frequently prescribed medication in children under age 12. It has indications for use in a wide variety of conditions such as high blood pressure, as a second-line medication in ADHD, treatment for Tourette syndrome, and treatment in some of the disruptive behavioral disorders, to name a few. Like all medications, it has some significant potential side effects that must be carefully monitored, but it is a very important medication in current pediatric use.
Thank you for your question.
Last Editorial Review: 2/20/2007