In the management of opioid withdrawal, which medication works by reducing noradrenergic hyperactivity from the locus coeruleus and alleviates symptoms such as piloerection, diaphoresis, and lacrimation?
- A Methadone
- B Buprenorphine
- C Clonidine ✓
- D Naloxone
Correct answer: C. Clonidine
Explanation
During opioid withdrawal, the locus coeruleus (LC) becomes hyperactive due to loss of mu-opioid inhibition, releasing excess norepinephrine. Clonidine, an alpha-2 adrenergic agonist, suppresses LC norepinephrine firing, thereby reducing autonomic symptoms of withdrawal (piloerection, sweating, lacrimation, diarrhea). It does not address craving or psychological symptoms. Methadone and buprenorphine are mu-opioid agonists that prevent withdrawal by substitution but work via opioid receptors, not directly on noradrenergic pathways. Naloxone precipitates withdrawal.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.