Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents
Nicholas T Bello Department of Animal Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA Abstract: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate a...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2015-06-01
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| Series: | Patient Preference and Adherence |
| Online Access: | http://www.dovepress.com/clinical-utility-of-guanfacine-extended-release-in-the-treatment-of-ad-peer-reviewed-article-PPA |
| _version_ | 1819075200975634432 |
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| author | Bello NT |
| author_facet | Bello NT |
| author_sort | Bello NT |
| collection | DOAJ |
| description | Nicholas T Bello Department of Animal Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA Abstract: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR). As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. Keywords: Intuniv, norepinephrine, prefrontal cortex, locus coeruleus, impulsivity, inattentive |
| first_indexed | 2024-12-21T18:21:38Z |
| format | Article |
| id | doaj.art-1c93cdbb1c2b472381b59e0f52509352 |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-21T18:21:38Z |
| publishDate | 2015-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-1c93cdbb1c2b472381b59e0f525093522022-12-21T18:54:31ZengDove Medical PressPatient Preference and Adherence1177-889X2015-06-012015default87788522398Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescentsBello NTNicholas T Bello Department of Animal Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA Abstract: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR). As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. Keywords: Intuniv, norepinephrine, prefrontal cortex, locus coeruleus, impulsivity, inattentivehttp://www.dovepress.com/clinical-utility-of-guanfacine-extended-release-in-the-treatment-of-ad-peer-reviewed-article-PPA |
| spellingShingle | Bello NT Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents Patient Preference and Adherence |
| title | Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents |
| title_full | Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents |
| title_fullStr | Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents |
| title_full_unstemmed | Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents |
| title_short | Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents |
| title_sort | clinical utility of guanfacine extended release in the treatment of adhd in children and adolescents |
| url | http://www.dovepress.com/clinical-utility-of-guanfacine-extended-release-in-the-treatment-of-ad-peer-reviewed-article-PPA |
| work_keys_str_mv | AT bellont clinicalutilityofguanfacineextendedreleaseinthetreatmentofadhdinchildrenandadolescents |