Clonidine in the management of treatment resistant adolescent-onset mania: A case report
Introduction: Treatment of early-onset mania proves to be challenging in the face of chronicity and comorbidities, especially when the conventional anti-manic medications are ineffective or poorly tolerated.
Case history: A 14-year-old girl with moderate intellectual disability, presented with symptoms suggestive of manic episode without psychotic symptoms. Poor tolerability of the first-line antimanic medications namely lithium, valproate, risperidone, quetiapine, and aripiprazole impeded the effective management of the episode. In this background, addition of clonidine was followed by significant reduction in the severity of core manic symptoms.
Discussion: Clonidine has been found to be effective in hyperadrenergic states including mania, particularly in a subset of refractory patients as well as those who have poor tolerability to lithium and antipsychotic drugs.