{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:09:11Z","timestamp":1792346951057,"version":"4.4.0"},"reference-count":44,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Non-stimulant guanfacine is a common second-line medication for attention-deficit hyperactivity disorder (ADHD). Numerous randomized controlled trials (RCTs) have explored the efficacy of guanfacine in ADHD treatment. This meta-analysis combined data from selected RCTs to analyze the efficacy and safety of guanfacine in treating ADHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>RCTs were identified from published sources through searches in PubMed, Cochrane Library, Web of Science, and Embase (up to February 2022), defining the Clinical Global Impression of Improvement (CGI-I) treatment response score of \u22642 as the primary outcome. Subgroup analysis was performed with a bound treatment duration of 10 weeks. Safety was defined by treatment-emergent adverse events (TEAEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twelve out of 332 studies with 2653 participants were included. All studies compared guanfacine with placebos. Guanfacine was significantly more effective in treating ADHD (Risk Ratio [RR] 1.78, 95% CI: 1.59\u20132.01). In the &lt;10 weeks subgroup, the efficacy in the guanfacine group compared with the placebo group was 58.5% versus 29.4%, respectively (RR 1.97, 95% CI: 1.71\u20132.26). In the &gt;10 weeks subgroup, the efficacy in the guanfacine group compared with the placebo group was 63.6% versus 39.7%, respectively (RR 1.57, 95% CI: 1.37\u20131.79). Both subgroups lacked heterogeneity (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090), and a funnel plot showed a low publication bias risk. Around 80% of participants in the guanfacine group experienced at least one TEAE, compared with 66.5% in the placebo group (RR 1.23, 95% CI: 1.14\u20131.32), with low heterogeneity (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200946,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.05). The most common TEAEs in the guanfacine group were somnolence (38.6%), headaches (20.5%), and fatigue (15.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Guanfacine is safe and effective for treating ADHD, with no serious adverse events. Guanfacine should be considered as an effective treatment option where effectiveness or tolerability of the central nervous system stimulant is of concern. There is stronger evidence of efficacy for children; more clinical studies are needed for adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2022.0038","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T15:14:13Z","timestamp":1679411653000},"page":"40-50","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Guanfacine for the Treatment of Attention-Deficit Hyperactivity Disorder: An Updated Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4587-8461","authenticated-orcid":false,"given":"Sijie","family":"Yu","sequence":"first","affiliation":[{"name":"The Second Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou, China."},{"name":"The Second Affiliated Hospital, Zhejiang Chinese Medicine University, Hangzhou, China."},{"name":"Zhejiang Provincial People's Hospital, Hangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihao","family":"Shen","sequence":"additional","affiliation":[{"name":"The Forth Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou, China."},{"name":"Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Tao","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou, China."},{"name":"The Second Affiliated Hospital, Zhejiang Chinese Medicine University, Hangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.08-11-04287.1988"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.08.019"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900017107"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-3695"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.112679"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.12.017"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-018-0116-3"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2019.1706480"},{"key":"e_1_3_3_10_1","first-page":"755","article-title":"Effects of guanfacine extended release on oppositional symptoms in children aged 6\u201312 years with attention-deficit hyperactivity disorder and oppositional symptoms: A randomized, double-blind, placebo-controlled trial","volume":"24","author":"Connor DF","year":"2010","unstructured":"Connor DF, , Findling RL, , Kollins SH, , Sallee F, , L\u00f3pez FA, , Lyne A, , Tremblay G: Effects of guanfacine extended release on oppositional symptoms in children aged 6\u201312 years with attention-deficit hyperactivity disorder and oppositional symptoms: A randomized, double-blind, placebo-controlled trial. 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