Alpha-2 agonists (central)
- Reduce central sympathetic outflow
- Clonidine/guanfacine lower BP + arousal
- ADHD: guanfacine/clonidine ER
- Clonidine: withdrawal + autonomic uses
- Sedation, bradycardia, dry mouth
- Abrupt clonidine stop → rebound hypertension
- Guanfacine generally causes less rebound
Class at a glance
- Reduce central sympathetic outflow
Clinical role
- ADHD: guanfacine/clonidine ER
- Clonidine: withdrawal + autonomic uses
Practical pearls
- Clonidine/guanfacine lower BP + arousal
Safety / monitoring
- Sedation, bradycardia, dry mouth
- Abrupt clonidine stop → rebound hypertension
- Guanfacine generally causes less rebound
Self-check
- What do Alpha-2 agonists (central) primarily reduce?
Central sympathetic outflow. - What can abrupt clonidine discontinuation cause?
Rebound hypertension.
Drugs in this class (7)
Alpha-2 agonists (central) prescription history
Animated chart of estimated U.S. prescriptions per year, Antihypertensives (1953–2026). Central agents highlighted from 1953.
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