Systemic Medication: Clonidine
Clonidine is a centrally active alpha-2 receptor agonist that decreases norepinephrine release. One small case series and several case reports have been published regarding its effect on hyperhidrosis. Clonidine reduced sweating in 2 women with paroxysmal localized hyperhidrosis, a rare condition that can be idiopathic, can be due to nervous system disease or can occur as a manifestation of gustatory sweating. The medication was also found to be helpful for 12 patients with the same diagnosis in a French case series. (Rev Neurol) A patient with excessive sweating due to tricyclic antidepressant use had a marked reduction in sweating with clonidine. In another report, a man with anxiety-induced facial and scalp hyperhidrosis found relief with the combination of clonidine and topical aluminum chloride. Lastly, clonidine has been reported helpful in a case of gustatory hyperhidrosis. (Archives of Physical Med Rehab).
Recently, the International Hyperhidrosis Society and two of its physician leaders conducted an in-depth webinar all about the use of oral medications, including clonidine, to treat hyperhidrosis. You can "watch the full video here." During this program, clonidine was discussed as being particularly useful in the treatment of situational sweating, craniofacial sweating, menopausal sweating, or sweating that's a side effect of another medication. Clonidine should be used on a regular basis to avoid severe changes in blood pressure.