Guanfacine use in children with attention deficit hyperactivity disorder.
The role of guanfacine in ADHD remains unclear. It may be reasonable to initiate a trial of guanfacine in a patient who has not responded to or cannot tolerate other agents due to adverse effects or drug dependence, or in a patient who develops motor tics. However, large placebo-controlled, double-blind, comparative trials involving guanfacine, stimulants, and/or TCAs are necessary to fully determine the role of guanfacine in the treatment of ADHD. Presently, behavioral modification is considered a first-line therapy and may be sufficient in mild cases of ADHD. Pharmacologic intervention or a combination of pharmacotherapy and behavioral modification should be tried in patients who cannot be adequately controlled with nonpharmacologic treatment. The stimulants still are considered first-line pharmacotherapy; however, guanfacine may have a role as a second- or third-line agent in patients who do not respond to or cannot tolerate stimulants or TCAs.
Cohn
L M
LM
Department of Pharmacy, Mount Sinai Medical Center, New York, NY 10029, USA.
Caliendo
G C
GC
D000293:Adolescent; D018663:Adrenergic Agents / Q000627:therapeutic use; D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D002986:Clinical Trials as Topic; D005260:Female; D016316:Guanfacine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use
D018663:Adrenergic Agents; D000316:Adrenergic alpha-Agonists; D000929:Antidepressive Agents, Tricyclic; D008774:Methylphenidate; D016316:Guanfacine