Dean Elbe1, Dorothy Reddy2. 1. Division of Children's and Women's Mental Health, BC Mental Health and Addiction Services, Vancouver, British Columbia ; Department of Pharmacy, BC Children's Hospital, Vancouver, British Columbia. 2. The Bellevue Clinic, West Vancouver, British Columbia.
Abstract
OBJECTIVE: To review the basic pharmacology and published literature regarding use of guanfacine extended-release (GXR) for the treatment of attention deficit/hyperactivity disorder in children and adolescents. METHODS: A LITERATURE REVIEW WAS CONDUCTED USING THE SEARCH TERMS: 'guanfacine', with limits set to: Human trials, English Language, and All Child (Age 0-18). Articles pertaining to guanfacine immediate-release or for indications other than attention deficit/hyperactivity disorder (ADHD) were not included for analysis. Additional articles were identified from reference information and poster presentation data. RESULTS: Six prospective, randomized controlled trials (RCT) and four open-label trials (including two long-term safety extension trials) were identified for GXR in the treatment of ADHD. All published RCTs showed superiority over placebo on the primary outcome measure. Subgroup analysis of available RCT data showed no efficacy of GXR at any dose in adolescents. Adverse effects in GXR trials were generally mild to moderate. High rates of early discontinuation were observed in long-term open-label extension trials. CONCLUSION: GXR is an effective option for treatment of ADHD in patients 6-12 years of age as monotherapy, or as adjunctive treatment to psychostimulants.
OBJECTIVE: To review the basic pharmacology and published literature regarding use of guanfacine extended-release (GXR) for the treatment of attention deficit/hyperactivity disorder in children and adolescents. METHODS: A LITERATURE REVIEW WAS CONDUCTED USING THE SEARCH TERMS: 'guanfacine', with limits set to: Human trials, English Language, and All Child (Age 0-18). Articles pertaining to guanfacine immediate-release or for indications other than attention deficit/hyperactivity disorder (ADHD) were not included for analysis. Additional articles were identified from reference information and poster presentation data. RESULTS: Six prospective, randomized controlled trials (RCT) and four open-label trials (including two long-term safety extension trials) were identified for GXR in the treatment of ADHD. All published RCTs showed superiority over placebo on the primary outcome measure. Subgroup analysis of available RCT data showed no efficacy of GXR at any dose in adolescents. Adverse effects in GXR trials were generally mild to moderate. High rates of early discontinuation were observed in long-term open-label extension trials. CONCLUSION: GXR is an effective option for treatment of ADHD in patients 6-12 years of age as monotherapy, or as adjunctive treatment to psychostimulants.
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