Guanfacine for the treatment of attention deficit hyperactivity disorder in children and adolescents

Abstract

Guanfacine is an α_2A-adrenoreceptor agonist currently indicated for the treatment of attention deficit hyperactivity disorder (ADHD). This article reviews the chemistry, pharmacodynamics and pharmacokinetics of guanfacine, as well as the clinical trial literature on guanfacine for the treatment of ADHD in children and adolescents, mainly focusing on the use of guanfacine extended-release (GXR). Six already published prospective randomized controlled trials (RCTs) and one unpublished RCT study were identified for GXR in the treatment of ADHD. All RCTs trials showed superiority over placebo on the primary outcome measure. Guanfacine, especially XR, seems to be an effective and safe treatment option for ADHD in children and adolescents.

Keywords:

• α₂-adrenoreceptor agonist
• attention deficit hyperactivity disorder
• guanfacine extended-release
• guanfacine immediate-release
• treatment

Financial & competing interests disclosure

R Rizzo worked on guanfacine trail SPD503-318. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder diagnosed in children and adolescents.

• Although effective stimulant treatment is available for ADHD, a substantial number of children do not respond adequately to the stimulants.

• Guanfacine extended-release formulation was shown to be an effective and safe treatment option for ADHD in children.