Which medication acts as an alpha-adrenergic agonist used in alcohol withdrawal management?

• A. Clonidine
• B. Guanfacine
• C. Prazosin
• D. Methyldopa

Answer: (A)

In alcohol withdrawal, the body’s sympathetic system becomes overactive, contributing to tremors, sweating, anxiety, tachycardia, and hypertension. An alpha-adrenergic agonist like clonidine helps by activating central alpha-2 receptors, which reduces norepinephrine release and dampens sympathetic outflow. This lowers the autonomic signs of withdrawal and can ease agitation and distress when used alongside benzodiazepines. Guanfacine is also an alpha-2 agonist but is not typically used for alcohol withdrawal management. Prazosin blocks alpha-1 receptors, which is a different mechanism and not the standard approach here. Methyldopa is a central alpha-2 agonist used for hypertension in pregnancy, not for alcohol withdrawal. Therefore, clonidine best fits the role of an alpha-adrenergic agonist used in alcohol withdrawal management.