Guanfacine in children with autism and/or intellectual disabilities
Abstract
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) affects 3%-5% of typical school-age children. However, considerably higher rates of ADHD (15%-25%) are observed in children with intellectual disability and autism. Studies of psychostimulants in the latter two populations have found poorer response rates compared to typically developing children. In addition, evidence suggests that children with developmental disabilities experience higher rates of adverse events. Guanfacine, an alpha2-adrenergic receptor agonist, has shown some promise as an alternative to psychostimulants. METHODS: The present study involved a double-blind, placebo-controlled, crossover trial of guanfacine in 11 children (ages 5-9 years) with developmental disabilities and symptoms of inattention/overactivity. The 6-week trial involved a maximum dose of 3 mg/day of guanfacine. RESULTS: Significant benefits were observed on the Hyperactivity subscale of the parent and teacher Aberrant Behavior Checklist (ABC) and Global Improvement Ratings. No gains were noted on other ABC subscales. Five of the 11 subjects (45%) were judged to be responders based on a 50% decrease in the ABC Hyperactivity subscale score between the placebo and guanfacine conditions. Several side effects were reported, including drowsiness and irritability. CONCLUSION: While guanfacine appears to be an alternative to psychostimulants among children with developmental disabilities, clinicians need to remain vigilant to the possibility of side effects.
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In two trials in children with pervasive developmental disorder accompanied by hyperactivity and impulsiveness, immediate-release guanfacine shows promise.
“there are 2 trials in children with pervasive developmental disorder accompanied by hyperactivity and impulsiveness in which immediate-release guanfacine shows promise”
From Catecholamine influences on prefrontal cortical function: Relevance to treatment of attention deficit/hyperactivity disorder and related disorders (2011) · cites this paper as Handen et al., 2008
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Hyman, S. L., Levy, S. E., Myers, S. M., COUNCIL ON CHILDREN WITH DISABILITIES, S. O. D. A. B. P., Kuo, D. Z., Apkon, S., Davidson, L. F., Ellerbeck, K. A., Foster, J. E. A., Noritz, G. H., et al. (2020) · Pediatrics · doi:10.1542/peds.2019-3447 · Cited by 1,548 · see citing works
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Extended-Release Guanfacine for Hyperactivity in Children With Autism Spectrum Disorder
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- Authors
- Handen, B. L., Sahl, R., & Hardan, A. Y.
- Affiliations
- University of Pittsburgh (US)
- Stanford University (US)
- Corresponding author
- Handen, Benjamin L.
- Venue
- Journal of Developmental & Behavioral Pediatrics
- Published
- 2008-08
- Volume
- 29
- Issue
- 4
- Pages
- 303-308
- ISSN
- 0196-206X (ISSN-L)
- OpenAlex
- W2076254448
- Cited by
- 126
- References
- 1
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 8 · 2018: 7 · 2017: 7 · 2016: 7 · 2015: 12 · 2014: 10 · 2013: 6 · 2012: 8
- FWCI
- 5.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Developmental & Behavioral Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- guanfacine, alpha-2 adrenergic agonists, autism spectrum disorder, intellectual disability, developmental disabilities, attention deficit hyperactivity disorder, inattention, hyperactivity, Aberrant Behavior Checklist, adverse effects, sleepiness, irritability
- MeSH terms
- Adrenergic alpha-Agonists, Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Child, Developmental Disabilities, Child, Preschool, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Humans, Male, Placebos, Psychiatric Status Rating Scales, Psychological Tests, Guanfacine, Treatment Outcome, Cross-Over Studies
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