ADHD in Children
Visual Abstract
Safety and Effectiveness of Coadministration of Guanfacine Extended Release and Psychostimulants in Children and Adolescents with Attention-Deficit=Hyperactivity Disorder
Guanfacine and Stimulants for ADHD
Thomas J. Spencer, M.D.,corresponding author Michael Greenbaum, M.D., Lawrence D. Ginsberg, M.D., and William Rory Murphy, M.D.
Summarized by:
May 11, 2023
study source
J Child Adolesc Psychopharmacol
Oct 2009
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What they studied
This study wanted to see if guanfacine could be safely taken alongside stimulant medications to further reduce ADHD symptoms.
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What they found
Most children experienced improvements in their ADHD symptoms after taking guanfacine. The most common side effects were abdominal pain and fatigue.
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What this means
While it's difficult to determine effectiveness in an open-label study, the data is consistent with other studies showing that guanfacine can effectively reduce ADHD symptoms.
Safety and Effectiveness of Coadministration of Guanfacine Extended Release and Psychostimulants in Children and Adolescents with Attention-Deficit=Hyperactivity Disorder
Objectives
ADHD is one of the most common psychiatric conditions among children. It is most commonly treated with stimulant medications, which have been shown to reduce ADHD symptoms effectively.
However, symptoms typically don’t go away completely, if at all, for many patients. There is a need for better or complementary treatment programs for ADHD.
The study wanted to see if guanfacine could be taken safely alongside stimulant medications to reduce ADHD symptoms in children further.
Study Quote
The aim of this study was to evaluate the safety and effectiveness of guanfacine extended release (GXR) administered concomitantly with psychostimulants in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and suboptimal response to a psychostimulant alone.
Methods
This study conducted an open-label trial, providing guanfacine to children taking either Ritalin or Adderall.
The children continued to take their regular medication, in addition to guanfacine, over a period of nine weeks.
They were monitored for any potential side effects or safety issues. Their ADHD symptoms were measured to evaluate their effectiveness.
Study Quote
This was a multicenter, open-label, 9-week, dose-escalation study of 75 subjects with ADHD treated with methylphenidate (MPH) or amphetamine (AMP) alone for at least 1 month, yet with suboptimal control of ADHD symptoms. Sixty-three subjects (84.0%) completed the study. Patients received...
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Results
The results showed that children taking Adderall or Ritalin experienced improvements in their ADHD symptoms once they started taking guanfacine.
Of note, this was an open-label study without a control group, which makes it difficult to determine how much of the improvement was due to the drug.
The most common side effects were abdominal pain, fatigue, and irritability.
Study Quote
The most common treatment-related AEs were upper abdominal pain (25.3%), fatigue (24.0%), irritability (22.7%), headache (20.0%), and somnolence (18.7%). Most AEs were mild to moderate in severity. Investigator-rated AEs due to blood pressure decreases, heart rate, or electrocardiogram f...
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Conclusions
This study found some evidence that guanfacine can be taken alongside Ritalin or Adderall.
However, the lack of a control group limits the data's usefulness. It’s hard to determine how much of the effectiveness or the side effects were caused by adding guanfacine.
Other more robust studies have demonstrated the effectiveness of guanfacine for ADHD:
Study Quote
Coadministration of GXR and MPH or AMP was generally safe and associated with statistically significant and clinically meaningful ADHD symptom improvement in children and adolescents.