Guanfacine extended release as adjunctive therapy to psychostimulants in children and adolescents with attention-deficit/hyperactivity disorder

Advances in Therapy

Volumn 29, Issue 5, 2012, Pages 385-400

  Childress, Ann C ^a  

^a Center for Psychiatry and Behavioral Medicine   (United States)

Author keywords

ADHD; Adjunctive therapy; Alpha 2A agonist; Amphetamine; Combination therapy; Guanfacine XR; GXR; Methylphenidate; Psychostimulants

Indexed keywords

ALPHA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; AMPHETAMINE DERIVATIVE; GUANFACINE; GUANFACINE EXTENDED RELEASE; LISDEXAMFETAMINE; METHYLPHENIDATE; PLACEBO; PSYCHOSTIMULANT AGENT; UNCLASSIFIED DRUG;

ABDOMINAL PAIN; ADOLESCENT; AREA UNDER THE CURVE; ATTENTION DEFICIT DISORDER; BODY HEIGHT; CHILD; CLINICAL PRACTICE; DECREASED APPETITE; DEPRESSION; DRUG BLOOD LEVEL; DRUG EFFICACY; DRUG FORMULATION; DRUG INDUCED HEADACHE; DRUG MECHANISM; DRUG METABOLISM; DRUG POTENTIATION; DRUG SAFETY; DRUG TOLERABILITY; EVENING DOSAGE; FATIGUE; HUMAN; HYPERSOMNIA; INSOMNIA; IRRITABILITY; MAXIMUM PLASMA CONCENTRATION; MENTAL INSTABILITY; MONOTHERAPY; MORNING DOSAGE; PHARYNGITIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; RHINOPHARYNGITIS; SEDATION; SIDE EFFECT; SINGLE DRUG DOSE; SOMNOLENCE; TREATMENT RESPONSE; UPPER ABDOMINAL PAIN; UPPER RESPIRATORY TRACT INFECTION; WEIGHT REDUCTION;

ADOLESCENT; ADRENERGIC ALPHA-2 RECEPTOR AGONISTS; ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY; CENTRAL NERVOUS SYSTEM STIMULANTS; CHILD; DELAYED-ACTION PREPARATIONS; DRUG ADMINISTRATION SCHEDULE; DRUG THERAPY, COMBINATION; GUANFACINE; HUMANS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 84863722106     PISSN: 0741238X     EISSN: 18658652     Source Type: Journal    
DOI: 10.1007/s12325-012-0020-1     Document Type: Review

References (70)

1. American Psychiatric Association. Attention-deficit and disruptive behavior disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, Fourth Edition. Text Revision. Washington, DC: American Psychiatric Association; 2000;85-93.
2. Bloom B, Cohen RA, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2007. Vital Health Stat. 2009;10:1-80.
3. Biederman J, Faraone SV. Attention-deficit hyperactivity disorder. Lancet. 2005;366:237-48. (Pubitemid 40981053)
4. Faraone SV, Pucci M, Coghill D. Pharmacotherapy for attention-deficit- hyperactivity disorder. US Psychiatry Rev. 2009;2:17-27.
5. Ryan-Krause P. Attention deficit hyperactivity disorder: part I. J Pediatr Health Care. 2010;24: 194-8.
6. Abikoff H, Hechtman L. Multimodal therapy and stimulants in the treatment of children with attention deficit hyperactivity disorder. In: Hibbs ED, Jensen PS, eds. Psychosocial Treatments for Child and Adolescent Disorders: Empirically Based Strategies for Clinical Practice. Washington, DC: APA Press; 1996:341-69.
7. Pelham WE Jr, Fabiano GA. Behavior modification. Child Adolesc Psychiatr Clin North Am. 2000;9:671-88, ix. (Pubitemid 30620549)
8. Biederman J. Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatry 2005;57: 1215-20. (Pubitemid 40798537)
9. Kossoff EH, Singer HS. Tourette syndrome: clinical characteristics and current management strategies. Paediatr Drugs. 2001;3:355-63. (Pubitemid 32506042)
10. Antshel KM, Hargrave TM, Simonescu M, Kaul P, Hendricks K, Faraone SV. Advances in understanding and treating ADHD. BMC Med. 2011;9:72.
11. Pliszka SR, Crismon ML, Hughes CW, et al, and The Texas Consensus Conference Panel on Pharmacotherapy of Childhood Attention-Deficit/ Hyperactivity Disorder. The Texas Children's Medication Algorithm Project: revision of the algorithm for pharmacotherapy of attentiondeficit/ hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006;45:642-57. (Pubitemid 43833097)
12. Cantwell DP. Attention deficit disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1996;35:978-87. (Pubitemid 26266328)
13. Scahill L, Chappell PB, Kim YS, et al. A placebocontrolled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. Am J Psychiatry 2001;158:1067-74. (Pubitemid 32623110)
14. Elia J, Ambrosini PJ, Rapoport JL. Treatment of attention-deficit- hyperactivity disorder. N Engl J Med. 1999;340:780-8.
15. Wood JG, Crager JL, Delap CM, Heiskell KD. Beyond methylphenidate: nonstimulant medications for youth with ADHD. J Atten Disord. 2007;11:341-50.
16. Pliszka S, the AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007;46:894-921.
17. Olfson M. New options in the pharmacological management of attention-deficit/hyperactivity disorder. Am J Manag Care. 2004;10(Suppl.):S117- 24. (Pubitemid 38970247)
18. Ramos-Quiroga JA, Casas M. Achieving remission as a routine goal of pharmacotherapy in attentiondeficit hyperactivity disorder. CNS Drugs. 2011;25: 17-36.
19. Steele M, Jensen PS, Quinn DMP. Remission versus response as the goal of therapy in ADHD: a new standard for the field? Clin Ther. 2006;28:1892-908. (Pubitemid 46038524)
20. Wilens TE. Combined pharmacotherapy in pediatric psychopharmacology: friend or foe? J Child Adolesc Psychopharmacol. 2009;19:483-4.
21. Ryan-Krause P. Attention deficit hyperactivity disorder: part III. J Pediatr Health Care. 2011;25: 50-6.
22. Pohl GM, Van Brunt DL, Ye W, Stoops WW, Johnston JA. A retrospective claims analysis of combination therapy in the treatment of adult attention-deficit/hyperactivity disorder (ADHD). BMC Health Serv Res. 2009;9:95.
23. Adler LA, Reingold LS, Morrill MS, Wilens TE. Combination pharmacotherapy for adult ADHD. Curr Psychiatry Rep. 2006;8:409-15. (Pubitemid 44515394)
24. Sallee FR. The role of alpha2-adrenergic agonists in attention-deficit/ hyperactivity disorder. Postgrad Med. 2010;122:78-87.
25. Hazell PL, Stuart JE. A randomized controlled trial of clonidine added to psychostimulant medication for hyperactive and aggressive children. J Am Acad Child Adolesc Psychiatry 2003;42:886-94. (Pubitemid 44515836)
26. Palumbo DR, Sallee FR, Pelham WE Jr, Bukstein OG, Daviss WB, McDermott MP. Clonidine for attention-deficit/hyperactivity disorder: I. Efficacy and tolerability outcomes. J Am Acad Child Adolesc Psychiatry 2008;47:180-8. (Pubitemid 351158786)
27. The Tourette's Syndrome Study Group. Treatment of ADHD in children with tics: a randomized controlled trial. Neurology. 2002;58:527-36.
28. Connor DF, Barkley RA, Davis HT. A pilot study of methylphenidate, clonidine, or the combination in ADHD comorbid with aggressive oppositional defiant or conduct disorder. Clin Pediatr. 2000;39:15-25. (Pubitemid 30044196)
29. Intuniv [package insert]. Wayne, PA: Shire Pharmaceuticals Inc.; 2011.
30. Kapvay [package insert]. Atlanta, GA: Shionogi Pharma, Inc.; 2010.
31. Kollins SH, Jain R, Brams M, et al. Clonidine extended-release tablets as add-on therapy to psychostimulants in children and adolescents with ADHD. Pediatrics. 2011;127:e1406-13.
32. Jain R, Segal S, Kollins SH, Khayrallah M. Clonidine extended-release tablets for pediatric patients with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2011;50:171-9.
33. Heal DJ, Cheetham SC, Smith SL. The neuropharmacology of ADHD drugs in vivo: insights on efficacy and safety. Neuropharmacology. 2009;57:608-18.
34. Fone KC, Nutt DJ. Stimulants: use and abuse in the treatment of attention deficit hyperactivity disorder. Curr Opin Pharmacol. 2005;5:87-93. (Pubitemid 40124540)
35. Markowitz JS, Patrick KS. Pharmacokinetic and pharmacodynamic drug interactions in the treatment of attention-deficit hyperactivity disorder. Clin Pharmacokinet. 2001;40:753-72. (Pubitemid 33027889)
36. Concerta [package insert]. Titusville, NJ: McNeil Pediatrics; 2010.
37. Bach MV, Coutts RT, Baker GB. Involvement of CYP2D6 in the in vitro metabolism of amphetamine, two N-alkylamphetamines and their 4-methoxylated derivatives. Xenobiotica. 1999;29:719-32. (Pubitemid 29371090)
38. Krishnan S, Moncrief S. An evaluation of the cytochrome p450 inhibition potential of lisdexamfetamine in human liver microsomes. Drug Metab Dispos. 2007;35:180-4. (Pubitemid 46036490)
39. Adderall XR [package insert]. Wayne, PA: Shire US Inc. 2010.
40. Vyvanse [package insert]. Wayne, PA: Shire US Inc.; 2012.
41. Markowitz JS, Straughn AB, Patrick KS. Advances in the pharmacotherapy of attention-deficithyperactivity disorder: focus on methylphenidate formulations. Pharmacotherapy. 2003;23:1281-99. (Pubitemid 37221923)
42. Pennick M. Absorption of lisdexamfetamine dimesylate and its enzymatic conversion to d-amphetamine. Neuropsychiatr Dis Treat. 2010;6:317-27.
43. Chavez B, Sopko MA Jr, Ehret MJ, et al. An update on central nervous system stimulant formulations in children and adolescents with attentiondeficit/ hyperactivity disorder. Ann Pharmacother. 2009;43:1084-95.
44. Faraone SV, Buitelaar J. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur Child Adolesc Psychiatry 2009;19:353-64.
45. Brams M, Moon E, Pucci M, Lopez FA. Duration of effect of oral long-acting stimulant medications for ADHD throughout the day. Curr Med Res Opin. 2010;26:1809-25.
46. Faraone SV, Biederman J, Morley CP, Spencer TJ. Effect of stimulants on height and weight: a review of the literature. J Am Acad Child Adolesc Psychiatry 2008;47:994-1009.
47. Hammerness PG, Perrin JM, Shelley-Abrahamson R, Wilens TE. Cardiovascular risk of stimulant treatment in pediatric attention-deficit/ hyperactivitydisorder: update and clinical recommendations. J Am Acad Child Adolesc Psychiatry 2011;50: 978-90.
48. Greenhill LL. Cautious reassurance: cardiovascular risk in the context of stimulant use. J Am Acad Child Adolesc Psychiatry 2012;51:132-3.
49. Vitiello B, Elliott GR, Swanson JM, et al. Blood pressure and heart rate over 10 years in the Multimodal Treatment Study of Children With ADHD. Am J Psychiatry 2012;169:167-77.
50. Franowicz JS, Kessler LE, Borja CM, Kobilka BK, Limbird LE, Arnsten AF. Mutation of the a2A-adrenoceptor impairs working memory performance and annuls cognitive enhancement by guanfacine. J Neurosci. 2002;22:8771-7. (Pubitemid 35387619)
51. Uhlén S, Wikberg JES. Delineation of rat kidney a2A and a2B-adrenoceptors with [3H]RX821002 radioligand binding: computer modelling reveals that guanfacine is an a2A-selective compound. Eur J Pharmacol. 1991;202:235-43.
52. Arnsten AFT, Li B-M. Neurobiology of executive functions: catecholamine influences on prefrontal cortical functions. Biol Psychiatry. 2005;57:1377-84. (Pubitemid 40798558)
53. 2 adrenoceptor and dopamine D1 receptor actions: relevance to therapeutic effects in attention deficit hyperactivity disorder. Behav Brain Funct. 2005;1:2.
54. 2A-adrenoceptors strengthen working memory networks by inhibiting cAMP-HCN channel signaling in prefrontal cortex. Cell. 2007;129:397-410. (Pubitemid 46574970)
55. Arnsten AF, Scahill L, Findling RL. Alpha-2 adrenergic receptor agonists for the treatment of attention-deficit/hyperactivity disorder: emerging concepts from new data. J Child Adolesc Psychopharmacol. 2007;17:393-406.
56. Biederman J, Melmed RD, Patel A, et al, the SPD503 Study Group. A randomized, doubleblind, placebo-controlled study of guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder. Pediatrics. 2008;121:e73-84.
57. Sallee F, McGough J, Wigal T, Donahue J, Lyne A, Biederman J, the SPD503 Study Group. Guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder: a placebo-controlled trial. J Am Acad Child Adolesc Psychiatry. 2009;48:155-165.
58. Connor DF, Findling RL, Kollins SH, et al. Effects of guanfacine extended release on oppositional symptoms in children aged 6-12 years with attention-deficit hyperactivity disorder and oppositional symptoms: a randomized, doubleblind, placebo-controlled trial. CNS Drugs. 2010;24:755-68.
59. Kollins SH, Lopez FA, Vince BD, et al. Psychomotor functioning and alertness with guanfacine extended release in subject with attentiondeficit/ hyperactivity disorder. J Child Adolesc Psychopharmacol. 2011;21:111-20.
60. Sallee FR, Lyne A, Wigal T, McGough JJ. Long-term safety and efficacy of guanfacine extended release in children and adolescents with attentiondeficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2009;19:215-26.
61. Biederman J, Melmed RD, Patel A, McBurnett K, Donahue J, Lyne A. Long-term, open-label extension study of guanfacine extended release in children and adolescents with ADHD. CNS Spectr. 2008;13:1047-55.
62. Faraone SV, Glatt SJ. Effects of extended-release guanfacine on ADHD symptoms and sedation-related adverse events in children with ADHD. J Atten Disord. 2009;13:532-8.
63. Haffey M, Ermer J, Roesch B, Buckwalter M, Martin P. Pharmacokinetics of coadministration of guanfacine extended release and methylphenidate extended release. Poster presented at the College of Psychiatric and Neurologic Pharmacists' Annual Meeting; May 1-4, 2011; Phoenix, AZ, USA.
64. Haffey M, Ermer J, Roesch B, Buckwalter M, Martin P. Pharmacokinetics of coadministration of guanfacine extended release and lisdexamfetamine dimesylate. Poster presented at the College of Psychiatric and Neurologic Pharmacists' Annual Meeting; May 1-4, 2011; Phoenix, AZ, USA.
65. Spencer TJ, Greenbaum M, Ginsberg LD, Murphy WR. Safety and effectiveness of coadministration of guanfacine extended release and psychostimulants in children and adolescents with attentiondeficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2009;19:501-10.
66. Wilens TE, Bukstein O, Brams M, et al. A controlled trial of extended-release guanfacine and psychostimulants for attention-deficit/ hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2012;51:74-85.
67. Mattingly G, McBurnett K, White C, Rubin J, Youcha S. Response of ADHD symptoms in children and adolescents treated with guanfacine extended release adjunctive to a psychostimulant. Poster presented at: American Academy of Child and Adolescent Psychiatry and Canadian Academy of Child and Adolescent Psychiatry Joint Annual Meeting; October 18-23, 2011; Toronto, ON, Canada.
68. Childress A. Extended-release guanfacine as adjunctive therapy to psychostimulants in the treatment of ADHD assessed in the morning and evening. Poster presented at: 164th Annual Meeting of the American Psychiatric Association; May 14-18, 2011; Honolulu, HI, USA.
69. Cutler A. Symptomatic remission of attentiondeficit/hyperactivity disorder in children and adolescents with adjunctive guanfacine extended release and a psychostimulant. Poster presented at: 164th Annual Meeting of the American Psychiatric Association; May 14-18, 2011; Honolulu, HI, USA.
70. Cutler AJ, Youcha S, White C, Rubin J. Impact of adjunctive guanfacine extended release and a psychostimulant on oppositional symptoms in children and adolescents with ADHD. Poster presented at: 164th Annual Meeting of the American Psychiatric Association; May 14-18, 2011; Honolulu, HI, USA.