{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:52:20Z","timestamp":1759179140865,"version":"3.44.0"},"reference-count":27,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["DTB"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>Prolonged-action \u25bcguanfacine (Intuniv\u2014Shire Pharmaceuticals Ltd) is a non-stimulant drug that has recently been licensed in Europe for the management of attention deficit hyperactivity disorder (ADHD) in children and adolescents aged 6\u201317 years for whom stimulants are unsuitable.<jats:sup>1<\/jats:sup> The company suggests that it has a unique mechanism of action in ADHD, providing improvement in core symptoms within 3 weeks with once-daily flexible dosing.<jats:sup>2<\/jats:sup> Here we review the evidence on the efficacy and safety of guanfacine in ADHD and consider whether it offers any advantages over other therapeutic options.<\/jats:p>","DOI":"10.1136\/dtb.2016.5.0402","type":"journal-article","created":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T10:12:56Z","timestamp":1463047976000},"page":"56-60","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["\u25bcGuanfacine for ADHD in children and\u00a0adolescents"],"prefix":"10.1136","volume":"54","member":"239","published-online":{"date-parts":[[2016,5,12]]},"reference":[{"key":"2025082701232568000_54.5.56.1","unstructured":"Intuniv 1mg, 2mg, 3mg, 4mg prolonged-release tablets. Summary of product characteristics, UK. Shire Pharmaceuticals Ireland Limited, September 2015."},{"key":"2025082701232568000_54.5.56.2","unstructured":"Personal communication. Medical information manager, Shire Pharmaceuticals."},{"key":"2025082701232568000_54.5.56.3","unstructured":"National Institute of Health and Care Excellence, 2016. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults (CG 72) [online]. Available: https:\/\/www.nice.org.uk\/guidance\/cg72\/ [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.4","doi-asserted-by":"publisher","DOI":"10.1177\/0269881113519509"},{"key":"2025082701232568000_54.5.56.5","doi-asserted-by":"crossref","unstructured":"Thomas R , et al . Attention-deficit\/hyperactivity disorder: are we helping or harming? BMJ 2013; 347: f6172. Correction: ibid 2014; 348: g4377.","DOI":"10.1136\/bmj.f6172"},{"key":"2025082701232568000_54.5.56.6","unstructured":"European Medicines Agency, 2015. Assessment report: Intuniv [online]. Available: http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Public_assessment_report\/human\/003759\/WC500195132.pdf [Accessed 20 January 2016]."},{"key":"2025082701232568000_54.5.56.7","unstructured":"National Institute of Health and Care Excellence, 2006. Methylphenidate, atomoxetine and dexamfetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents (TA 98) [online]. Available: https:\/\/www.nice.org.uk\/guidance\/ta98\/ [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.8","unstructured":"Food and Drug Administration, 2013. Description: Tenex (guanfacine hydrochloride) [online]. Available: http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2013\/019032s021lbl.pdf [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.9","unstructured":"European Medicines Agency, 2010. Guideline on the clinical investigation of medicinal products for the treatment of attention deficit hyperactivity disorder (ADHD) [online]. Available: http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Scientific_guideline\/2010\/08\/WC500095686.pdf [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.10","unstructured":"U.S. National Institutes of Health, 2014. ClinicalTrials.gov: Maintenance of Efficacy of Extended-Release Guanfacine HCl in Children and Adolescents With Attention-deficit\/Hyperactivity Disorder (ADHD) Study [online]. Available: https:\/\/clinicaltrials.gov\/ct2\/show\/study\/NCT01081145 [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.11","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1097\/01.CHI.0000070245.24125.B6","article-title":"Ten-year review of rating scales","volume":"42","author":"Collett","year":"2003","journal-title":"J Am Acad Adolesc Pych"},{"key":"2025082701232568000_54.5.56.12","first-page":"28","article-title":"The Clinical Global Impressions Scale: applying a research tool in clinical practice","volume":"4","author":"Busner","year":"2007","journal-title":"Psychiatry"},{"key":"2025082701232568000_54.5.56.13","unstructured":"National Institute for Health and Care Excellence, 2016. Attention deficit hyperactivity disorder in children and young people: guanfacine prolonged-release (ESNM70) [online]. Available: https:\/\/www.nice.org.uk\/guidance\/esnm70 [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.14","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/s12955-015-0379-1","article-title":"Psychometric validation of the Weiss Functional Impairment Rating Scale-Parent Report Form in children and adolescents with attention-deficit\/hyperactivity disorder","volume":"13","author":"Gajria","year":"2015","journal-title":"Health Qual Life Outcomes"},{"key":"2025082701232568000_54.5.56.15","unstructured":"Canadian Agency for Drugs and Technologies in Health, 2015. Common drug review: Guanfacine hydrochloride extended release (Intuniv XR) tablets [online]. Available: https:\/\/www.cadth.ca\/sites\/default\/files\/cdr\/clinical\/SR0349_IntunivXR_CL_Report_e.pdf [Accessed 20 April 2016]"},{"key":"2025082701232568000_54.5.56.16","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.7"},{"key":"2025082701232568000_54.5.56.17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-3695"},{"key":"2025082701232568000_54.5.56.18","doi-asserted-by":"publisher","DOI":"10.1097\/CHI.0b013e318191769e"},{"key":"2025082701232568000_54.5.56.19","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.jaac.2015.08.016","article-title":"A randomized, placebo-controlled trial of guanfacine extended release in adolescents with attention-deficit\/hyperactivity disorder","volume":"54","author":"Wilens","year":"2015","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2025082701232568000_54.5.56.20","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/j.euroneuro.2014.09.014","article-title":"Efficacy and safety of extended-release guanfacine hydrochloride in children and adolescents with attention-deficit\/hyperactivity disorder: a randomized, controlled, phase III trial","volume":"24","author":"Hervas","year":"2014","journal-title":"Eur Neuropsychopharmacol"},{"key":"2025082701232568000_54.5.56.21","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2008.0080"},{"key":"2025082701232568000_54.5.56.22","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1089\/cap.2008.0152","article-title":"Safety and effectiveness of coadministration of guanfacine extended release and psychostimulants in children and adolescents with attention-deficit\/hyperactivity disorder","volume":"19","author":"Spencer","year":"2009","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"2025082701232568000_54.5.56.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.10.012"},{"key":"2025082701232568000_54.5.56.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2014.08.001"},{"key":"2025082701232568000_54.5.56.25","unstructured":"European Medicines Agency, 2015. Summary of the risk management plan (RMP) for Intuniv (guanfacine) [online]. Available: http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Risk-management-plan_summary\/human\/003759\/WC500190181.pdf [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.26","unstructured":"Scottish Medicines Consortium, 2016. Guanfacine hydrochloride (Intuniv) [online]. Available: http:\/\/www.scottishmedicines.org.uk\/SMC_Advice\/Advice\/1123_16_guanfacine_hydrochloride_Intuniv\/guanfacine_hydrochloride_Intuniv [Accessed 20 April 2016]."},{"key":"2025082701232568000_54.5.56.27","unstructured":"All Wales Medicines Strategy Group, 2016. Guanfacine (Intuniv\u00ae) [online]. Available: http:\/\/www.awmsg.org\/awmsgonline\/app\/appraisalinfo\/2361 [Accessed 20 April 2016]."}],"container-title":["Drug and Therapeutics Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/dtb.2016.5.0402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:23:41Z","timestamp":1756283021000},"score":1,"resource":{"primary":{"URL":"https:\/\/dtb.bmj.com\/lookup\/doi\/10.1136\/dtb.2016.5.0402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,5,12]]},"published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1136\/dtb.2016.5.0402"],"URL":"https:\/\/doi.org\/10.1136\/dtb.2016.5.0402","relation":{},"ISSN":["0012-6543","1755-5248"],"issn-type":[{"type":"print","value":"0012-6543"},{"type":"electronic","value":"1755-5248"}],"subject":[],"published":{"date-parts":[[2016,5]]}}}