Are you considering Clonidine for Anxiety because you get a bad case of nerves and anxiety whenever you have to go on stage and perform for an audience?
Perhaps you’ve experienced increased heart rate, trembling hands and profuse sweat, to the point where it hinders your ability to perform at your absolute best.
Or perhaps you’re not a “performer” in the traditional sense, as in a musician or a public speaker, but you still suffer from jitters and nerves in high-pressure situations like job interviews or even a social event like a dinner party or a date.
If any of this sounds familiar, know that you are not alone in your suffering. Performance anxiety, often called stage fright, affects millions of people around the world and is pretty common. At its core is a fear of being judged negatively because of your performance, even if there is no solid/logical evidence to justify the fear.
Many professional musicians, public speakers, stand-up comedians and others struggling with anxiety turn to Clonidine to help them manage their symptoms. Here, we will look at how clonidine works for anxiety, any potential side-effects, dosages, possible alternatives and everything else you should consider before using clonidine to help with anxiety symptoms.
But before we dive into why Clonidine may help some performers with their anxiety, let’s take a look at why you experience performance anxiety and social anxiety in the first place. Knowing why you experience anxiety symptoms will help you better understand why drugs like Clonidine, or other natural alternatives, may be effective against your stage fright symptoms.
Clonidine for Anxiety Key Takeaways
Without completely spoiling the rest of this article, here are the most interesting & useful takeways about Clonidine for Anxiety:
- Clonidine is an alpha2-agonist and is typically used to treat high blood pressure in adults, and treatment of attention deficit/hyperactivity disorder (AD/HD) and tic disorders (such as Tourette syndrome) for children and adolescents. Clonidine works by inhibiting secretion of the neurotransmitter norepinephrine, often called noradrenaline. Norepinephrine effects blood pressure, heart rate and anxiety, as well as attention and arousal. So lowering secretion leads to lowered blood pressure and ultimately to feelings of calm and relaxation. In turn, symptoms of AD/HD, anxiety, sleep difficulties, nicotine withdrawal, and tic disorders are improved.
- Clonidine is not a beta blocker, even though it is sometimes used off-script by performers and those looking to help their performance anxiety symptoms. When taken by adults, the typical dose of Clonidine for anxiety purposes is between 0.1mg and 0.8mg per day in divided doses.
Why do I experience performance anxiety?
If you suffer from performance anxiety, then for one reason or another, performing in front of others is a significantly stressful experience for you. Maybe you fear that a less-than-perfect performance will result in rejection, pain, or loss of future opportunities. Whatever the reason: you are experiencing performance anxiety due to an exaggerated stress response.
Your fear and worry about performing results in a stress response within your body, and it triggers the release of specific stress hormones. Too much of these stress hormones put your cardiovascular system into overdrive, which results in shaking, sweating, nausea, and other symptoms of stage fright .
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Why do performers take Clonidine?
Clonidine is available under the commercial names Catapres, Dixarit and in generic forms. The full name of the medication is clonidine hydrochloride and it is a prescription drug (at least within the US).
What is Clonidine and how does it work to help with anxiety symptoms?
Clonidine belongs to a group of medications called “alpha2-agonists” and it’s typically prescribed to treat high blood pressure in adults. In children and adolescents, Clonidine can be used for other conditions, including treatment of attention deficit/hyperactivity disorder (AD/HD) and tic disorders (such as Tourette syndrome).
Clonidine works by affecting the activity of the brain chemical (neurotransmitter) called norepinephrine (also referred to as noradrenaline). Norepinephrine normally influences blood pressure, heart rate and anxiety in the body, but it also affects attention and arousal. Clonidine inhibits the secretion of norepinephrine, leading to lowered blood pressure and feelings of calm and relaxation. This in turn improves symptoms of AD/HD, anxiety, sleep difficulties, nicotine withdrawal, and tic disorders .
Studies have shown that the main effect of clonidine is to decrease anxiety attacks and “psychic” symptoms . As mentioned, it was originally designed to treat high blood pressure (hypertension) and so it makes sense that clonidine would be effective against anxiety symptoms.
Effects of clonidine persist for around 8 hours for an average, healthy adult. Individuals who begin taking clonidine for anxiety report a reduction in symptoms after around 7-10 days, although this length of time can vary from person to person.
Besides hypertension and the above-mentioned conditions, Clonidine is also used to treat a multitude of conditions, including :
- Diabetic neuropathy
- Menopausal flushing
- Menstrual cramps
- Alcohol withdrawal
- Benzodiazepine withdrawal
- Opioid withdrawal
- Restless leg syndrome
Is Clonidine a beta-blocker?
Beta-blockers are also known as beta-adrenergic blocking agents. Their main function is to block the release of adrenaline and other stress hormones. Beta blockers are typically prescribed for health conditions like high blood pressure, angina (chest pains), irregular heart rhythm (arrhythmia), and migraines .
It is commonly known that beta-blockers have also long been used by performers to deal with anxiety and stage fright.
As explained above, an exaggerated stress response like when you experience performance anxiety, is associated with a dramatic spike in adrenaline.
So, by blocking the effects of adrenaline, you’re preventing it from binding to the beta receptors in the heart. So, beta-blockers essentially block the physical symptoms of performance anxiety.
When you take a beta-blocker, it can slow your heart rate, reduce the trembling and sweating, and regulate your breathing and blood pressure. It can help you feel relaxed, essentially negating the stress response to help you get through the performance .
As clonidine belongs to a class of drugs called central alpha-adrenergic agonists (or adrenergic α2 agonist), so no Clonidine is not a beta blocker.
Although both clonidine and beta-blockers like Propranolol and Metoprolol are prescribed to treat high blood pressure (hypertension), they do so through different mechanisms and usage of both without professional medical assistance and advice is NOT advised. Please seek professional medical assistance if you are currently combining beta blockers with clonidine, as improper withdrawal can cause issues such as severe hypertension and “unopposed alpha agonism” .
What is the recommended Clonidine dosage for anxiety?
When taken by adults, the typical dose of Clonidine for Hypertension is an initial oral dose of 0.1mg 2 times per day (morning and bedtime). The recommended maintenance dose for hypertension is 0.2mg to 0.6mg orally per day in divided doses, and the maximum recommended dose for hypertension is 2.4mg orally per day in divided doses .
For anxiety, it is best to seek professional medical assistance for help with dosages, but several reports place the recommended clonidine dosage between 0.1mg and 0.8mg per day in divided doses .
Are there any downsides or side-effects to using Clonidine for anxiety?
As with any medication, clonidine can cause side effects, especially when taken in combination with other substances or medications. Reported common side effects of clonidine include the following :
- Drowsiness (try taking the dose at bedtime. Do not drive or operate machinery until you know how this medication affects you. If daytime clonidine doses make you drowsy, talk with your doctor.)
- Dry mouth (try chewing sugarless gum or sucking hard sugar-free candies, ice chips, or popsicles)
- Dry eyes (try using artificial tears eye drops)
- Dizziness, lightheadedness or low blood pressure (try getting up slowly from a sitting or lying down position. If it becomes severe (for example: falling or fainting), seek medical help immediately)
- Headache (try using a pain reliever like acetaminophen (Tylenol®). If your headache comes on suddenly and is extremely intense, seek emergency help immediately)
- Constipation (try drinking more fluids, exercising, or increasing the amount of fiber in your diet)
- Stomach upset, nausea, vomiting (try taking clonidine following a meal)
More serious but less common side effects of clonidine (occurring in less than 5% of patients) include the following. Please contact your doctor IMMEDIATELY if you have any of these potentially serious side effects:
- Skin rash with swelling and itching or trouble breathing
- Worsened depression (prolonged sadness) or other unusual changes in mood
- Fast or slow heart rate, irregular heart beat
- Increased agitation, restlessness or irritability
- Sudden onset of high blood pressure, fast heart beat, agitation, headache, stomach upset, sweating, nausea or vomiting (This may happen if clonidine treatment is stopped suddenly. If these effects occur, seek emergency help immediately) 
Clonidine requires a prescription
Do note that, assuming your doctor approves of you taking clonidine for your anxiety, and writes a prescription, you’ll have to refill that prescription every time you run out.
This will not be an issue if you only plan on using clonidine a few times (note that for hypertension and many other uses, two weeks on clonidine continuously is recommended). But if you start using clonidine more often, then it could become a significant inconvenience.
Are there any natural alternatives to Clonidine?
If you’re not too excited about becoming dependent on clonidine when you want or need to perform, or having to get a prescription whenever you run out, you may be wondering if there are natural alternatives to clonidine.
A natural alternative would achieve the same end-result, which is to provide relief from symptoms of performance anxiety.
But it would do so by supporting your mind and body in a way that, over time, makes you more resilient. You’d become better equipped to handle the stress response and learn to think about your performance in a way that makes it less stressful, to begin with.
Here are some of the most effective natural remedies to performance anxiety.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is a form of therapy designed to modify your thoughts in a way that makes the idea of performing less stressful for you .
The goal of CBT is to take something you find overwhelming, like speaking or playing music in front of an audience, and break it down into smaller parts. Your therapist will help you understand the thoughts and emotions that are responsible for your anxiety, and how you can adjust your perceptions about performing in a positive way.
To get started, your therapist will learn as much as possible about you, and your challenges with performance anxiety. Instead of thinking of a performance as one big event, they might ask you to think of it in smaller pieces. For example, you might only think about the part where up to the podium, or when your teammate hands you the ball when the game is on the line.
The point of the exercise is to help you identify your thoughts associated with each smaller part. It will help you understand how your thought patterns and self-talk can affect you emotionally, and how they might be contributing to your anxiety.
As you go through the process of CBT, your therapist may recommend certain activities or even give you homework. He or she might encourage you to apply some of what you’re learning in real-life situations to start rewiring your brain in a different way.
CBT has been shown to be effective in treating a variety of anxiety disorders, especially in the long term when patients stick with the therapy .
Yoga can help your fight against anxiety by improving how you respond to stress. Research has shown that yoga increases your heart rate variability (HRV), which is the difference in the time interval between heartbeats. A higher HRV indicates your body’s increased ability to deal with stress .
A regular yoga practice can make you more resilient in stressful situations, and improve how your body reacts to prevent anxiety symptoms like heart palpitations and trembling.
According to an article in Harvard Health, yoga can work as a natural anxiety relief by reducing the impact of an exaggerated stress response, which is precisely what causes stage fright .
PerformZen Calm Performance Formula
PerformZen is a supplement designed to help you remain calm and focused during a performance. It combines GABA, L-theanine, magnesium, and vitamin B6, so they work synergistically to support your brain. These ingredients promote calmness (GABA, L-theanine, magnesium), as well as a state of energized focus (magnesium, vitamin B6).
Together, they will help you achieve that state of “flow” where you can perform at your highest level.
But that’s not all. PerformZen also contains two additional powerful ingredients to fight off stage fright: Theacrine and Ginkgo Biloba.
Theacrine is a naturally occurring substance found in a Chinese tea known as Kucha. It has a similar energy-boosting effect as coffee but without the jitters or the ups and downs . It also promotes mental clarity, which, along with the energy boost, could be beneficial before and during a performance.
Ginkgo Biloba has been traditionally used for healing purposes in Chinese medicine. It is a herb rich in antioxidants that has various benefits for brain health. Evidence shows that Ginkgo Biloba can help you manage your stress hormone levels, which keeps your fight-or-flight response under control and prevents the symptoms of anxiety .
All combined, PerformZen is a potent formula when it comes to fighting performance anxiety. As a natural supplement, it promotes calmness, focus, and optimal cognitive performance.
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So can Clonidine help with anxiety? The conclusion
You don’t have to let anxiety control you and prevent you from doing the thing you love, which is performing for an audience. Or perhaps getting jittery has been affecting your professional or personal life.
Medications like clonidine can provide a much-needed relief from the physical anxiety symptoms so you can get through what you need to do.
But Clonidine, or any other drug, will never be the solution you’re really looking for, which is to not be fearful about performing in front of an audience in the first place.
To overcome performance anxiety in the long term, consider natural alternatives like cognitive behavioral therapy (CBT), yoga, and a natural supplement like PerformZen.
In the meantime, If you are considering Clonidine as a quick-fix for your anxiety symptoms, be sure to consult with your doctor to make sure it is right for you.
- ^ https://performanceanxiety.com/how-to-overcome-stage-fright/
- ^ https://keltymentalhealth.ca/r/clonidine-catapresr-dixaritr
- ^ https://jamanetwork.com/journals/jamapsychiatry/article-abstract/492671
- ^ https://justbelieverecoverypa.com/clonidine-for-anxiety/
- ^ https://performanceanxiety.com/beta-blockers-for-anxiety/
- ^ https://performzen.com/propranolol-for-anxiety/
- ^ https://www.pharmacyjoe.com/why-should-beta-blockers-be-tapered-before-clonidine/
- ^ https://www.drugs.com/clonidine.html
- ^ https://www.karger.com/Article/Fulltext/446441
- ^ https://www.webmd.com/vitamins/ai/ingredientmono-1280/theacrine
- ^ https://journals.sagepub.com/doi/full/10.1177/2010105817716184
- ^ https://socialanxietyinstitute.org/comprehensive-cognitive-behavioral-therapy-social-anxiety-disorder
- ^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/
- ^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959333/
- ^ https://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression