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Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents

机译：胍法辛缓释剂在儿童和青少年多动症治疗中的临床应用

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Abstract: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR). As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD.
机译：摘要：注意缺陷多动障碍（ADHD）是儿童和青少年中最常见的精神疾病。几种兴奋剂，如哌醋甲酯和苯丙胺衍生物，可用于治疗小儿多动症。一些父母，其他照顾者和患者更喜欢非兴奋性药物，因为它们缺乏刺激性药物的滥用潜力。在美国，一种可用的非兴奋剂选择是胍法辛缓释（XR）。胍法辛作为选择性的α2A肾上腺素能受体，作用于中枢去甲肾上腺素能途径和皮质去甲肾上腺素能靶标，以改善工作记忆和注意力。与速释制剂相比，胍法辛的XR制剂对ADHD的长期治疗更有效，且不良反应较少。现有数据还表明，胍法辛XR优于阿莫西汀，并且与非选择性α2肾上腺素能受体激动剂可乐定XR一样有效。与胍法辛XR相关的最常见不良反应是嗜睡，疲劳，心动过缓和低血压。嗜睡是最常被提及的停药原因。胍法辛XR也被标记用作ADHD刺激治疗的佐剂。当将胍法辛XR“添加”到兴奋剂治疗中时，据报道，与单药治疗相似的不良反应情况是，嗜睡症是最常见的不良事件。这篇综述基于有关该药物治疗ADHD的安全性，相对有效性和耐受性的可用公开数据，讨论了胍法辛XR的临床疗效和患者偏爱。

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