Guanfacine Extended-Release Tablets (Intuniv), a Nonstimulant Selective Alpha(2A)-Adrenergic Receptor Agonist For Attention-Deficit/Hyperactivity Disorder.

Abstract

Attention deficit/hyperactivity disorder (ADHD) is one of the most common childhood diagnoses. Symptoms, which can continue through adolescence and adulthood, include difficulties in staying focused, paying attention, controlling behavior, and managing hyperactivity or overactivity.1 Children with ADHD may struggle with low self-esteem, troubled relationships, and poor performance in school.1,2 In 2006 in the U.S., ADHD was diagnosed in about 4.5 million children 5 to 17 years of age.3 From 3% to 7% of school-aged children have ADHD. In some studies, estimated rates are higher in community samples.1 Stimulants constitute the first-line treatment for ADHD in children. The response rate is approximately 70%, based on reduced hyperactivity or increased attention, as rated by parents, teachers, or researchers.4,5 At least 80% of children respond to one stimulant medication. For those who do not respond to a particular stimulant because of intolerable side effects, another recommended stimulant medication should be tried.6 Nonstimulants are also used in children or adolescents who show a fair response to stimulants or who experience adverse effects from them. Currently, atomoxetine (Strattera, Lilly) is indicated for the treatment of ADHD in children six years of age and older, teenagers, and adults. Extended-release (long-acting) guanfacine HCl (Intuniv, Shire), approved by the FDA in 2009, is used as part of a treatment program to control symptoms of ADHD in children and adolescents 6 to 17 years of age, but it is not approved for adults with ADHD. Combination therapy comprising both atomoxetine and guanfacine, along with behavioral and psychological interventions, is often beneficial in ADHD.7