Guanfacine for Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and/or Oppositional Defiance Disorder

Key Messages

• This review identified 4 relevant systematic reviews, 2 randomized controlled trials and 1 guideline since 2017.
• The systematic reviews and trials suggest that guanfacine is more clinically effective than placebo for improving symptoms of attention-deficit/ hyperactive disorder, however it may be associated with increased adverse events such as abdominal pain and fatigue.
• There is some suggestion from 2 systematic reviews that guanfacine may be equally effective as other psychostimulants or non-psychostimulants, with the potential for more greater side effects, but the evidence is highly uncertain.
• The included guideline has a strong recommendation to offer guanfacine for use in children and adolescents when psychostimulants have failed, or they are not tolerable.
• No evidence was identified on the cost-effectiveness of guanfacine relative to psychostimulants, non-psychostimulants or placebo that met the inclusion criteria.