title: Clinical and Pharmacologic Considerations for Guanfacine Use in Very Young Children.
abstract: Guanfacine, in the immediate release form, remains a commonly used medication for the treatment of clinically significant hyperactivity, impulsivity, or disruptive behaviors. This article reviews the available literature regarding guanfacine use in very young children (<6 years of age), and explores some of the factors that may uniquely impact the clinical pharmacology of guanfacine in very young children and that deserve consideration when it is used in this patient population.
  
  
  
  The authors performed electronic literature searches in PubMed through October 2015 using the terms attention-deficit/hyperactivity disorder, guanfacine, and alpha agonists. We also performed an informal review of the literature and used selected articles from relevant reference lists. The result was a broad, qualitative review of the literature, with a focus on specific factors regarding guanfacine use in very young children.
  
  
  
  Despite the fact that guanfacine is commonly used in very young children, there is a paucity of published studies that looked specifically at its use in this population. In reviewing the pharmacology of guanfacine, there are specific factors that may play a unique role in its disposition in very young children.
  
  
  
  Guanfacine is an important medication option in very young children; however, there is a significant pharmacologic "information gap," and further research is needed to help establish appropriate, safe, and effective dosing of guanfacine in this population.
authors.affiliation: 1 Division of Developmental & Behavioral Sciences, Children's Mercy Hospital , Kansas City, Missouri.
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Black
authors.affiliation: 1 Division of Developmental & Behavioral Sciences, Children's Mercy Hospital , Kansas City, Missouri.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Soden
authors.affiliation: 1 Division of Developmental & Behavioral Sciences, Children's Mercy Hospital , Kansas City, Missouri.|2 Arkansas Children's Hospital Research Institute , Arkansas Children's Hospital, Little Rock, Arkansas.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Kearns
authors.affiliation: 3 Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy Hospital , Kansas City, Missouri.
authors.forename: Bridgette L
authors.initials: BL
authors.lastname: Jones
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002675:Child, Preschool; D016316:Guanfacine / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D006948:Hyperkinesis / Q000188:drug therapy; D007175:Impulsive Behavior / Q000187:drug effects; D000066553:Problem Behavior
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D016316:Guanfacine