Guanfacine Hydrochloride Extended Release

Key Messages

• Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder most commonly identified in children and adolescents that often continues into adulthood. It is an impairment of the ability to regulate attention or focus. ADHD can present differently in different people. Some symptoms may include forgetfulness, impulsivity, disorganization, distracted behaviour, and restlessness. People with ADHD can also experience emotional dysregulation. These factors may contribute to learning challenges, problems with self-esteem, and difficulties with relationships.

  In Canada, the prevalence of ADHD in children and adolescents combined is estimated to range from 2.6% to 8.6%. The prevalence is thought to be higher in males (range, 3.7% to 13.3%) than in females (range, 1.5% to 7.0%).

• The treatment goals for children and adolescents with ADHD are to reduce hyperactivity, impulsivity (including aggressive impulsive actions), inattention, oppositional behaviours, and emotional dysregulation to improve their development (e.g., learning, social development, cognitive outcomes, and health-related quality of life [HRQoL]).

  Methylphenidate and dextroamphetamine (or mixed amphetamine salts) preparations are common psychostimulant (PST) medications used as first-line treatment to target symptoms.

  However, PST treatment is not helpful to all patients, particularly those with certain medical conditions. This includes those who cannot tolerate PSTs due to their adverse effects; those whose disease does not have a clinical response to PSTs; those for whom optimized PST use results in only a partial disease response; and those whose families may feel strongly that PST medications are not a good option for them.

  Guanfacine hydrochloride extended release (GXR), a nonstimulant medication, could be used as a second-line treatment as monotherapy or as adjunctive therapy to a PST for patients whose disease responds suboptimally to PSTs alone.