CLONIDINE POISONING - AN EMERGING PROBLEM - EPIDEMIOLOGY, CLINICAL-FEATURES, MANAGEMENT AND PREVENTATIVE STRATEGIES

Objective: To ascertain whether the incidence of clonidine poisoning i n children has increased given the probable increase in clonidine use for treatment of childhood behavioural disorders. Methods: Cases of cl onidine poisoning requiring hospital admission between 1985-95 inclusi ve were reviewed and demographic data pertinent to each admission were recorded. A literature review was also performed, with particular emp hasis on incidence, clinical presentation and management of clonidine poisoning. Results: There were 14 cases of clonidine poisoning during the specified period eight cases presenting in the last 2 years. These eight children or their siblings had been prescribed clonidine for be havioural disorders. The most common signs at presentation were altera tion of concious state (71%) and bradycardia (50%). Nine children were given activated charcoal while seven cases underwent gastric lavage o r induced emesis. Although six children were admitted to intensive car e, length of hospital stay was less than 24 h in all cases and all had a favourable outcome. Conclusion: We concluded that the incidence of clonidine poisoning had increased over the specified period and that, based on our results, this was likely to be due to an increase in clon idine use in childhood behavioural disorders. Based on our data and th at from literature review it was evident that there are inconsistencie s in the management of clonidine poisoning and that safety measures, n amely packaging and education, are inadequate given the increasing pro file of clonidine use.