Guanfacine Plus Stimulant Improves ADHD Symptoms
the Psychiatry Advisor take:
A medication that was first approved to treat high blood pressure has been shown to significantly improve symptoms of attention-deficit/hyperactivity disorder (ADHD) when used as an adjunct to psychostimulants.
To determine whether guanfacine extended-release (GXR) in combination with a psychostimulant medication resulted in better response and remission rates in children and adolescents with ADHD than psychostimulants alone, Andrew J. Cutler, MD, of the Florida Clinical Research Center in Bradenton, Florida and colleague, conducted a nine-week, double-blind, placebo-controlled trial.
They randomly assigned 461 participants aged 6 to 17 years with ADHD to receive GXR and a stimulant either on awakening or at bedtime, or a psychostimulant plus placebo. All participants had previously been treated with psychostimulants but had suboptimal responses to treatment.
The primary outcome was a reduction from baseline in ADHD Rating Scale IV (ADHD-RS-IV) total score. The researchers also assessed symptomatic and syndromal remission.
Participants assigned to combination treatment with GXR and a psychostimulant achieved a greater ADHD-RS-IV score reduction compared to those who received a psychostimulant alone, (GXR am + psychostimulant = 69.8%; GXR pm + psychostimulant = 70.3%; placebo + psychostimulant = 57.9%; P=0.032 and P=0.026, respectively), the researchers found.
Similar outcomes were noted on symptomatic remission (ADHD-RS-IV total score ≤18; 61.1%, 62.2%, versus 46.1%; P=0.010 and P=0.005, respectively),
The adverse event profile of combination treatment was consistent with known effects of either treatment alone, with the most common being headache (21.2%) and somnolence (13.6%).
The FDA approved use of guanfacine for ADHD in 2010, either with or without stimulants. In animal models, guanfacine was seen to affect a number of cognitive factors, including working memory improvement, distractibility reduction, response inhibition improvement, and enhanced attention and impulse control.
Guanfacine Improves Attention-Deficit Hyperactivity Disorder Symptoms When Added to a Stimulant Medication
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Adjunctive Therapies for Bipolar Disorder Show Promise, Need More Evidence
- Improving Performance of Everyday Activities Is Critical in Schizophrenia
- Analysis Finds Lithium Maintenance Most Effective as Monotherapy in Bipolar Disorder
- Web-Based Intervention Targets Parental Behaviors That May Affect Adolescent Anxiety, Depression
- Abnormalities of Cortical Thickness in Bipolar Disorder With Auditory Hallucinations
- The Way to the Head May Be Through the Gut: Probiotics for Depression
- Suicide-Screening Toolkit Can Help Identify Youths at High Risk for Suicide
- Agoraphobia: An Evolving Understanding of Definitions and Treatment
- Parental Pressure to Diet Linked With Long-term Harm in Adolescents
- Does Access to Medical Cannabis Reduce Risk for Opioid Abuse?
- Antidepressants Increase Seizure Risk in Youth and Severely Depressed
- Examining Associations Between Diabetes and Effects on Cognition
- Untreated Depression Common in Women of Childbearing Age
- Incidence of Psychiatric Disorders in Rheumatoid Arthritis
- Effect of Antidepressant Class, Dose on Pediatric Anxiety Disorders