Background and Importance The management of complex trauma in children and adolescents is difficult because of his multidimensional nature. Research into this area is particularly challenging and very few clinical studies are available. Clonidine is used off-label in our country for this indication.

Aim and Objectives The aim of this work is to study the prescribing practices of clonidine in children and adolescents with complex trauma : the pre-therapeutic assessment, the targeted symptoms, the galenic formulation and the tolerance.

Material and Methods National distribution of a questionnaire via the mailing of the Psychiatry Information Communication network and the Federative Association of Psychiatric Students of our country to find out about the practices of prescribing clonidine in other health establishments. Questionnaire validated upstream by the referent child psychiatrist then extraction of the answers and descriptive analysis of the data collected.

Results 88 responses were obtained, 58% from psychiatrists and 38% from residents in psychiatry with at least one response per region. The analysis shows the use of Clonidine, especially in tablet form, as a last resort and very often in combination medication. Among the 25 people who answered the entire questionnaire, good tolerance was observed in 84% of cases, the remaining 12% reported episodes of hypotension or headaches. A pre-therapeutic assessment with electrocardiogram, blood pressure and pulse are carried out in 72% of cases and clinical efficacy is observed in 76% of cases, in particular on nightmares, insomnia and anxiety.

Conclusion and Relevance Preliminary data seem to indicate that clonidine could have a positive clinical impact on certain symptoms of complex trauma. A multicentre, double-blind clinical study, Clonidine versus placebo, on a larger sample and taking into account the environmental context of the child, could make it possible to confirm or not this hypothesis.

References

1. Briere J, Scott C. Complex Trauma in Adolescents and Adults: Effects and Treatment. Psychiatr Clin North Am. sept 2015;38(3):515–27.

2. Lustig SL, Botelho C, Lynch L, Nelson SV, Eichelberger WJ, Vaughan BL. Implementing a randomised clinical trial on a paediatric psychiatric inpatient unit at a children’s hospital: the case of clonidine for post-traumatic stress. Gen Hosp Psychiatry. déc 2002;24(6):422–9.

Conflict of Interest No conflict of interest