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. 2020 Jul;40(7):1050-1055.
doi: 10.1038/s41372-020-0685-2. Epub 2020 May 18.

Clonidine versus phenobarbital as adjunctive therapy for neonatal abstinence syndrome

Carrie Brusseau  1 , Tara Burnette  2 , R Eric Heidel  3
Affiliations

Clonidine versus phenobarbital as adjunctive therapy for neonatal abstinence syndrome

Carrie Brusseau et al. J Perinatol. 2020 Jul.

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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