ArticleFrontiers in child and adolescent psychiatry2026
Guanfacine extended-release use in diagnostic diversity and symptom complexity.
Article in Frontiers in child and adolescent psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This retrospective chart review examined clinical changes in ADHD symptoms and global functioning following guanfacine extended-release (GXR) initiation in a diagnostically heterogeneous clinical sample of children and adolescents with ADHD. Methods: Thirty-eight children and adolescents aged 6-18 years with ADHD, with or without comorbid neurodevelopmental or psychiatric conditions, who were prescribed guanfacine extended-release were included in the tolerability analysis. Pre-post clinical outcome analyses were conducted in 33 patients who continued GXR for at least three months and had follow-up scale assessments available between weeks 4 and 12 after treatment initiation. Clinical data, including ADHD-related rating scales and autism-related clinical measures, were obtained retrospectively from medical records. Diagnoses were based on DSM-5 criteria, and psychiatric comorbidities were assessed using K-SADS-PL. Results: Of the participants, 76.3% were male. All participants had ADHD, and 63.2% had comorbid ASD. The mean final weight-adjusted GXR dose was 0.05 ± 0.03 mg/kg/day. Adverse effects were reported in 28.9% of patients, most commonly restlessness. Among 33 patients with follow-up assessments obtained between weeks 4 and 12, median CGI-S scores decreased from 5 to 3, while GAS scores increased from 55 to 75. ADHD symptom ratings decreased in most Turgay scale subdomains, particularly attention deficit, hyperactivity/impulsivity, and oppositional defiant symptoms. Conclusion: Guanfacine extended-release use was associated with improvements in ADHD symptom ratings and global functioning in this retrospective clinical sample. Adverse effects were observed in a clinically relevant subset of patients and led to discontinuation in some cases. Given the retrospective design, lack of a control group, small sample size, and concomitant medication use, these findings should be interpreted as preliminary real-world observations.
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