Guanfacine treatment of hyperactivity and inattention in pervasive developmental disorders: a retrospective analysis of 80 cases.

OBJECTIVE: The aim of this study was to retrospectively review a large sample of children and adolescents with pervasive developmental disorders (PDDs) treated with open-label guanfacine in order to gather preliminary data as to its effectiveness and safety.
METHOD: Eighty (80) subjects with PDDs (10 females, 70 males) (mean +/- SD age = 7.7 +/- 3.5 years, range 3-18 years) were treated with guanfacine within an academic specialty clinic. Charts were reviewed to determine the response of specific target symptoms, including hyperactivity, inattention, and impulsivity. The relationship between treatment response and age, diagnosis, level of cognitive impairment, and symptom severity was determined. Adverse effects were also evaluated.
RESULTS: Guanfacine (mean daily dose = 2.6 +/- 1.7 mg, range 0.25-9 mg; mean duration of treatment = 334 +/- 374 days, range 7-1776 days) treatment was effective in 19 of 80 (23.8%) subjects. Subjects with PDD not otherwise specified (11 of 28 responders; 39.3%) and Asperger's disorder (2 of 6 responders; 33.3%) showed a greater rate of global response than those with autistic disorder (6 of 46 responders; 13.0 %). There was a trend for subjects without comorbid mental retardation (9 of 24 subjects; 37.5%) to respond at a greater rate than those with mental retardation (10 of 56 subjects; 17.9%). Symptom improvement was seen in hyperactivity, inattention, insomnia, and tics. Guanfacine was well tolerated, and did not lead to significant changes in blood pressure or heart rate.
CONCLUSIONS: Guanfacine may have a role in the treatment of hyperactivity and inattention occurring in some persons with PDDs. Further studies are needed to determine its efficacy in this population.