title: Guanfacine and secondary mania in children.
abstract: BACKGROUND
  Guanfacine hydrochloride is an alpha-2 adrenergic agonist, which has gained recent attention in the field of child and adolescent psychiatry. This medication has been described as effective in the management of attention-deficit hyperactivity and tic disorders, with minimal side effects.
  
  
  METHODS
  Presented here are five cases of behavioral activation in children treated with guanfacine.
  
  
  RESULTS
  In each instance the clinical presentation resembled an acute hypomanic or manic episode. The dose of guanfacine was 0.5 mg/day. Later investigation revealed that all of the youngsters had clear risk factors (clinical and/or familial) for bipolar disorder.
  
  
  CONCLUSIONS
  It appears as though guanfacine may be capable of precipitating secondary mania in vulnerable children.
authors.affiliation: Division of Child Psychiatry, UNC Hospitals, Chapel Hill 27599-7160, USA. jhorrigan@css.unc.edu
authors.forename: J P
authors.initials: JP
authors.lastname: Horrigan
authors.forename: L J
authors.initials: LJ
authors.lastname: Barnhill
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D001714:Bipolar Disorder / Q000139:chemically induced*; D002648:Child; D005260:Female; D016316:Guanfacine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012307:Risk Factors; D013565:Sympatholytics / Q000009:adverse effects* / Q000627:therapeutic use; D005879:Tourette Syndrome / Q000188:drug therapy
chemical_list: D013565:Sympatholytics; D016316:Guanfacine