{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:45:00Z","timestamp":1787010300714,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Clonidine is being increasingly prescribed in pediatric populations for behavioral conditions such as attention-deficit\/hyperactivity disorder (ADHD), contributing to a rise in pediatric exposures and toxic ingestions. This article reviews the toxicokinetics, clinical presentation, and management of pediatric clonidine toxicity. Children under 5 years old account for the highest proportion of clonidine exposures, most of which are unintentional. Clonidine toxicity mimics an opioid toxidrome, often presenting with CNS depression, miosis, bradycardia, and hypotension. Diagnosis is primarily clinical. While supportive care remains the core component of treatment, naloxone may be beneficial in reversing CNS depression, though higher-than-standard doses are often required. Given the potential for delayed and prolonged toxicity, particularly with ingestion of transdermal patches, early recognition and intervention are critical. This review equips clinicians to understand, diagnose, and manage pediatric clonidine toxicity, emphasizing the importance of supportive care and consideration of naloxone for severe cases.<\/jats:p>","DOI":"10.1097\/pec.0000000000003476","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T19:00:36Z","timestamp":1764615636000},"page":"969-975","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Pediatric Clonidine Toxicity"],"prefix":"10.1097","volume":"41","author":[{"given":"Raizada A.","family":"Vaid","sequence":"first","affiliation":[{"name":"3rd year Emergency Medicine Resident, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, SUNY Upstate Medical University"},{"name":"7th Year Fellow in Pediatric Emergency Medicine and Medical Toxicology, Department of Emergency Medicine, Upstate New York Poison Center, SUNY Upstate Medical University, Syracuse, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayan","family":"Shakeri","sequence":"additional","affiliation":[{"name":"3rd year Emergency Medicine Resident, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, SUNY Upstate Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Conners","sequence":"additional","affiliation":[{"name":"3rd year Emergency Medicine Resident, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, SUNY Upstate Medical University"},{"name":"Exchange Administrative Group, Department of Pediatrics, Upstate Golisano Children\u2019s Hospital, Syracuse, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"R1-20251201","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0733-8627(03)00059-2","article-title":"Pediatric toxicologic concerns","volume":"20","author":"Abbruzzi","year":"2002","journal-title":"Emerg Med Clin North Am"},{"key":"R2-20251201","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1111\/jpc.14155","article-title":"Use of psychotropic medications in general paediatric practice","volume":"54","author":"Hazell","year":"2018","journal-title":"J Paediatr Child Health"},{"key":"R3-20251201","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1159\/000446441","article-title":"Clonidine use in psychiatry: panacea or panache?","volume":"98","author":"Naguy","year":"2016","journal-title":"Pharmacol"},{"key":"R4-20251201","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1001\/jama.283.8.1025","article-title":"Trends in the prescribing of psychotropic medications to preschoolers","volume":"283","author":"Zito","year":"2000","journal-title":"JAMA"},{"key":"R5-20251201","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12245-019-0231-1","article-title":"Outcomes following clonidine ingestions in children: an analysis of poison control center data","volume":"12","author":"Amico","year":"2019","journal-title":"Int J Emerg Med"},{"key":"R6-20251201","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1136\/archdischild-2018-316026","article-title":"Clonidine exposures in children under 6 (2004-2017): a retrospective study","volume":"104","author":"Cairns","year":"2019","journal-title":"Arch Dis Child"},{"key":"R7-20251201","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1080\/15563650.2023.2268981","article-title":"2022 Annual Report of the National Poison Data System (NPDS) from America\u2019s Poison Centers: 40th Annual Report","volume":"61","author":"Gummin","year":"2023","journal-title":"Clin Toxicol (Phila)"},{"key":"R9-20251201","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1046\/j.1365-2044.1999.00659.x","article-title":"alpha-2 and imidazoline receptor agonists. 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