title: Guanfacine ER for the treatment of adolescent attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Guanfacine extended release (GXR) is an alpha 1A noradrenergic agonist that has been approved by the FDA for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) as a monotherapy, and as an adjunctive therapy to stimulants for the treatment of ADHD in children and adolescents age 6 - 17.
  
  
  METHODS
  PubMed, the Ovid Medline database, and the PsycInfo database were searched using the term 'guanfacine'. Results were then limited to criteria such as English and human, from 1990 through December 2011. The resulting yield from the comprehensive literature search was 4391 articles. The titles and abstracts of all articles were reviewed. Studies were selected for full-text review based upon their place in the hierarchy of evidence (e.g., randomized controlled trials), relevance and quality of individual studies, and generalizability to clinical practice. The search was augmented by further search of article reference lists. A total of 15 articles were selected for full-text examination.
  
  
  CONCLUSIONS
  Due to the absence of positive evidence for the efficacy of GXR for monotherapy in adolescents, clinicians should be guarded in the use of GXR for monotherapy in adolescents with ADHD. The use of GXR has considerable promise as an adjunct to stimulants for other behavioral conditions associated with ADHD.
authors.affiliation: WPIC, 1941 East Rd., Houston, TX 77054, USA. oscar.g.bukstein@uth.tmc.edu
authors.forename: Oscar Gary
authors.initials: OG
authors.lastname: Bukstein
authors.forename: Jared
authors.initials: J
authors.lastname: Head
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000378:metabolism; D003692:Delayed-Action Preparations / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016316:Guanfacine / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D003692:Delayed-Action Preparations; D016316:Guanfacine