Comparing clonidine and dexmedetomidine effects in the treatment of opiate withdrawal syndrome in poisoned patients

Abstract

Background

While opiate withdrawal syndrome (OWS) typically resolves within a few weeks, the discomfort in the initial days after discontinuing opioid use is intense. In this study, we compared the effects of 2 drugs, clonidine and dexmedetomidine, for treating OWS in patients admitted to the Toxicology ICU at Loghman-e Hakim Hospital.

Methods

We collected patient information for individuals diagnosed with OWS in this clinical trial study. Fifty-two patients, matched based on the type of drug use (methadone, opiate, heroin), were included and divided into 2 groups. We compared the clinical effects of 2 drugs, dexmedetomidine and clonidine, on OWS symptoms using the Clinical Opiate Withdrawal Scale (COWS). The dexmedetomidine group received a dosage of 0.5 mcg/kg/h continuous IV infusion; not to exceed 24 h, while the clonidine group received 1.2 mg per day for 24 h. We completed the COWS standard checklist and compared the results after 0, 12, and 24 h.

Results

At Zero hours' patients who were administered dexmedetomidine had a significantly higher average COWS score of 0.684, compared to a score of 0.053 for patients who received clonidine (p-value = .000201). At the 12-h, the distinction between the 2 treatment groups was no longer statistically significant, as evidenced by a p-value of .162829 (dexmedetomidine: 0.105 vs. clonidine: 0.000).

Conclusions

The results suggest that dexmedetomidine is superior to clonidine in reducing withdrawal symptoms. The study found that both medications had a significant decrease in COWS scores over time, indicating their effectiveness in alleviating withdrawal symptoms as time passed.