Photo Credit: Brownie Harris
The following is a summary of “Clonidine as Monotherapy for Neonatal Opioid Withdrawal Syndrome: A Randomized Trial,” published in the October 2024 issue of Pediatrics by Bada et al.
Infants are affected by Neonatal opioid withdrawal syndrome (NOWS) when exposed to opioids during pregnancy. Non-opioid treatment options are being explored to manage the condition effectively.
Researchers conducted a prospective study to evaluate the effectiveness of clonidine in treating NOWS.
They randomized 120 neonates with NOWS, aged ≤7 days and with prenatal opioid exposure, to receive either oral clonidine (1 µg/kg/dose) or morphine (0.06 mg/kg/dose) every 3 hours. Treatment duration was determined by response, with adjunct therapy given if needed.
The results showed that the length of treatment did not differ between clonidine and morphine groups, with median (95% CI treatment durations of 17 (15–19) days for clonidine and 15 (13–17) days for morphine (P=.48). However, 45% of clonidine-treated infants required adjunct therapy, compared to 10% in the morphine group (aOR = 8.85 [2.87–27.31]). Neurobehavioral scores, assessed using the NICU Network Neurobehavioral Scales, did not differ between clonidine-treated and morphine-treated infants.
They concluded that clonidine was an effective non-opioid treatment for NOWS, with similar treatment duration and neurobehavioral outcomes as morphine. Further research is needed to optimize clonidine dosage for quicker responses.
