Objective: To report a case of deliberate ingestion of a clonidine hydrochloride patch in an adult.
Case summary: A patient at a psychiatric hospital with a diagnosis of major depression and polysubstance abuse was administered a clonidine patch for opiate detoxification. The patient subsequently chewed and swallowed the patch (total clonidine content: 5 mg); he was subsequently transferred to a nearby general medical hospital for management of obtundation and profound sinus bradycardia.
Discussion: The use of clonidine in withdrawal states is discussed. The primary adverse effects attributable to clonidine overdose, hypotension, and profound sinus bradycardia, may be managed symptomatically. Accidental ingestion of clonidine patches by infants and children has previously been reported in the literature. This is the first reported case of deliberate ingestion of a clonidine patch in an adult.
Conclusions: Before initiating topical clonidine therapy for chemical withdrawal states, patients should be evaluated carefully for suicide potential and a history of previous suicide attempts. If a patient expresses suicidal ideation or has attempted suicide in the past, he is probably not a candidate for topical clonidine therapy in either the inpatient or outpatient setting.