Combined abuse of clonidine and amitriptyline in a patient on buprenorphine maintenance treatment

J. Paul Seale, Trent Dittmer, Erika J. Sigman, Holly Clemons, J. Aaron Johnson

Research output: Contribution to journalArticle

3 Scopus citations


Buprenorphine/naloxone maintenance therapy is often prescribed in primary care to treat opioid dependence. Previous reports have described concomitant abuse of opioids and clonidine. In this case, a primary care patient on buprenorphine/naloxone maintenance therapy demonstrating alteredmental status, hallucinations, falls, and rebound hypertension was found to be concomitantly abusing clonidine and amitryptyline, which share metabolic pathways with buprenorphine. Clinicians should be aware of patients' combining amitryptyline, clonidine, and gabapentin with buprenorphine to achieve a mood altering state, avoid co-prescribing them if possible, and maintain communication with pharmacies and other providers when they are prescribed.

Original languageEnglish (US)
Pages (from-to)476-478
Number of pages3
JournalJournal of Addiction Medicine
Issue number6
Publication statusPublished - Nov 1 2014
Externally publishedYes



  • Antidepressive agents
  • Buprenorphine [MeSH]
  • Clonidine
  • Naloxone
  • Receptors opioid [MeSH]
  • Tricyclic

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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