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Clonidine versus phenobarbital as adjunctive therapy for neonatal abstinence syndrome

Journal of Perinatology volume 40, pages 1050–1055 (2020)Cite this article

Subjects

Abstract

Objective

To compare clonidine versus phenobarbital as adjunctive therapy in infants who failed monotherapy with morphine for neonatal abstinence syndrome (NAS).

Study design

Prospective, randomized, open-label study of infants ≥ 35 weeks’ gestation. Infants received clonidine or phenobarbital per protocol. Primary outcome was morphine treatment days. Secondary outcomes were inpatient adjunctive days, length of stay (LOS), triple therapy, safety, and readmission rates.

Results

A total of 25 infants were treated with clonidine (n = 14) or phenobarbital (n = 11). Mean morphine treatment duration was significantly longer with clonidine (34.4 days, SD = 10.6) compared with phenobarbital (25.5 days, SD = 7.3, p = 0.026). The clonidine group also had higher inpatient adjunctive days (mean: 33.8 days [SD = 14.3] vs. 22 days [SD = 12.6], p = 0.042) and LOS (mean: 41.8 days [SD = 10.9] vs. 31 days [SD = 10]; p = 0.018) compared with phenobarbital.

Conclusions

Phenobarbital, as adjunctive therapy, led to significantly shorter duration of morphine therapy, inpatient adjunctive days, and length of stay compared with clonidine.

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Fig. 1: Flow chart of study participants.

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Author information

Authors and Affiliations

  1. Department of Pharmacy, University of Tennessee Medical Center, Knoxville, TN, USA

    Carrie Brusseau

  2. Department of Neonatology, University of Tennessee Medical Center, Knoxville, TN, USA

    Tara Burnette

  3. Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA

    R. Eric Heidel

Authors
  1. Carrie Brusseau
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  2. Tara Burnette
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  3. R. Eric Heidel
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Contributions

CB was responsible for the study concept, design, data collection and interpretation, and preparation of the manuscript. TB was responsible for the study concept, design, data collection and interpretation, and critical review of the manuscript. REH was responsible for study design, data interpretation, and critical review of the manuscript.

Corresponding author

Correspondence to Carrie Brusseau.

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The authors declare that they have no conflict of interest.

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Brusseau, C., Burnette, T. & Heidel, R.E. Clonidine versus phenobarbital as adjunctive therapy for neonatal abstinence syndrome. J Perinatol 40, 1050–1055 (2020). https://doi.org/10.1038/s41372-020-0685-2

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