Elbe Dean, Reddy Dorothy
Division of Children's and Women's Mental Health, BC Mental Health and Addiction Services, Vancouver, British Columbia ; Department of Pharmacy, BC Children's Hospital, Vancouver, British Columbia.
The Bellevue Clinic, West Vancouver, British Columbia.
J Can Acad Child Adolesc Psychiatry. 2014 Feb;23(1):48-60.
To review the basic pharmacology and published literature regarding use of guanfacine extended-release (GXR) for the treatment of attention deficit/hyperactivity disorder in children and adolescents.
A LITERATURE REVIEW WAS CONDUCTED USING THE SEARCH TERMS: 'guanfacine', with limits set to: Human trials, English Language, and All Child (Age 0-18). Articles pertaining to guanfacine immediate-release or for indications other than attention deficit/hyperactivity disorder (ADHD) were not included for analysis. Additional articles were identified from reference information and poster presentation data.
Six prospective, randomized controlled trials (RCT) and four open-label trials (including two long-term safety extension trials) were identified for GXR in the treatment of ADHD. All published RCTs showed superiority over placebo on the primary outcome measure. Subgroup analysis of available RCT data showed no efficacy of GXR at any dose in adolescents. Adverse effects in GXR trials were generally mild to moderate. High rates of early discontinuation were observed in long-term open-label extension trials.
GXR is an effective option for treatment of ADHD in patients 6-12 years of age as monotherapy, or as adjunctive treatment to psychostimulants.
综述关于使用缓释胍法辛（GXR）治疗儿童和青少年注意力缺陷/多动障碍的基础药理学及已发表文献。
采用检索词“胍法辛”进行文献综述，限定条件为：人体试验、英语、所有儿童（0 - 18岁）。不纳入与速释胍法辛相关或用于注意力缺陷/多动障碍（ADHD）以外适应症的文章进行分析。从参考文献信息和海报展示数据中识别其他文章。
共识别出六项关于GXR治疗ADHD的前瞻性随机对照试验（RCT）和四项开放标签试验（包括两项长期安全性扩展试验）。所有已发表的RCT在主要结局指标上均显示优于安慰剂。对现有RCT数据的亚组分析表明，GXR在任何剂量下对青少年均无疗效。GXR试验中的不良反应一般为轻至中度。在长期开放标签扩展试验中观察到高停药率。
GXR作为单一疗法或作为精神兴奋剂的辅助治疗，是治疗6 - 12岁ADHD患者的有效选择。
