Guanfacine extended-release for attention-deficit/hyperactivity disorder (ADHD).
BACKGROUND
Guanfacine extended-release (GXR) is a non-stimulant approved in the US for treatment of attention deficit/hyperactivity disorder (ADHD). GXR is a 'first in class' α(2A)-adrenoceptor agonist reformulated to optimize efficacy. GXR enters a rapidly growing but crowded ADHD market as an alternative not only to psychostimulants but also to atomoxetine.


METHODS
Pharmacodynamics, pharmacokinetics, clinical efficacy and safety of GXR are covered based on a literature review (MEDLINE and EMBASE) from 1980 to 2010. Two large pivotal controlled trials are reviewed along with companion safety studies over 24 months. Collateral studies in ADHD children with oppositional symptoms and combination use of GXR in psychostimulant partial-responders are featured.


RESULTS
Novel aspects of apparent GXR mechanism of action may complement existing treatments. Study evidence indicates that GXR is a well-tolerated and effective treatment for children and adolescents with ADHD, and appears efficacious to reduce oppositional symptoms in children with these complicating features. The GXR safety database reflects mild and asymptomatic decreases in both blood pressure and heart rate throughout, with most adverse events being somnolence-related and time-limited.


CONCLUSIONS
This review of GXR will allow the reader to determine the place for GXR in the ADHD treatment landscape.
Sallee
Floyd R
FR
University of Cincinnati, Department of Psychiatry, OH 45219, USA. floyd.sallee@uc.edu
Eaton
Katherine
K
D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000818:Animals; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000378:metabolism; D002986:Clinical Trials as Topic / Q000379:methods; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000493:pharmacokinetics; D016316:Guanfacine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D016896:Treatment Outcome
D058647:Adrenergic alpha-2 Receptor Agonists; D003692:Delayed-Action Preparations; D016316:Guanfacine