Extended-Release Guanfacine Hydrochloride is Safe and Effective as Mono- and Adjunctive Therapy in Children and Adolescents with ADHD: A Naturalistic, Multi-Center, Patient-Reported Outcome Measures-Based Study

Kutuk, Meryem; Tufan, Ali; Kilicaslan, Fethiye; Tastepe, Neslihan; Imrek, Yasemin; Adiguzel Akman, Oznur; ALŞEN GÜNEY, SEVAY; BAYKARA, HÜSEYİN; Bayraktar, Fadime; AKAY, AYNUR; Korkmaz, Gulenay; Ozcan, Seda; Ozbaran, Nazli; Aksu, Gulen; Toros, Fevziye; Uzun Cakir, Aylin; Cakir, Burak; Koksal, Merve; Oz, Hansa; Kara, Aziz; Ozkan, Yekta; Celikkol Sadic, Cagla; Gercek, Hacer; Polat Tuysuz, Berna; Kilic Guder, Ayse; Mutlu, Caner; Eray Camli, Safak; Turan, Serkan; Onal, Bedia; Yitik Tonkaz, Gulsum; Cobanoglu Osmanli, Cansu; Sahin, Berkan; Unver, Hatice; Tekeoglu, Ugur; NARALAN, YÜKSEL; Kabukcu Basay, Burge; Basay, Omer; Buber, Ahmet; Furkan Tanir, Muhammed; Gumussoy, Ahmet; Cimen, Irem; Yildiz Gundogdu, Ozlem; Yildirim Demirdogen, Esen; Bozkurt, Abdullah; Akinci, Mehmet; Buran, Burcin; Ozyurt, Gonca; Ozdag, Veysel; Sahin, Nilfer; Karagoz, Duygu; Turan, Bahadir; Hosoglu, Esra; Korkmaz, Ifakat; Gunduz Cilci, Yagmur; Esnafoglu, Erman; Ikiz, Esra; Subasi Turgut, Fatma; Ozturk, Masum; Kayis, Hakan; Benk Durmus, Fatma; Comertoglu Arslan, Semiha; Altun, Hatice; Ogutlu, Hakan; Avcil, Sibelnur; Bilgic, Berrin; Dincer, Mustafa; Gur Kurcaloglu, Neslisah; Bozatli, Leyla; Aykutlu, Hasan; Budagova, Gunay; Bilginer, Cilem; Cansiz, Mehmet; Kandemir, Hasan; Gokcen, Cem; Inal, Neslihan; Ercan, Eyup

doi:10.1177/10870547261492120

Extended-Release Guanfacine Hydrochloride is Safe and Effective as Mono- and Adjunctive Therapy in Children and Adolescents with ADHD: A Naturalistic, Multi-Center, Patient-Reported Outcome Measures-Based Study

Kutuk M. O., Tufan A. E., Kilicaslan F., Tastepe N., Imrek Y., Adiguzel Akman O., ...Daha Fazla

JOURNAL OF ATTENTION DISORDERS, 2026 (SCI-Expanded, SSCI, Scopus)

Yayın Türü: Makale / Tam Makale
Basım Tarihi: 2026
Doi Numarası: 10.1177/10870547261492120
Dergi Adı: JOURNAL OF ATTENTION DISORDERS
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, Education Abstracts, EMBASE, ERIC (Education Resources Information Center), MEDLINE, Psycinfo
Recep Tayyip Erdoğan Üniversitesi Adresli: Evet

Özet

Aims: Attention-deficit hyperactivity disorder (ADHD) is characterized by impairing and age-inappropriate inattention, hyperactivity, and impulsivity. Extended-release guanfacine hydrochloride (GXR) is a selective alpha 2A-adrenergic agonist approved as mono- and adjunctive therapy to psychostimulant medications for ADHD. This multicenter retrospective study aimed to assess patients with ADHD initiating treatment with GXR as mono- and adjunctive therapy in a non-Western, real-world clinical setting.Methods: The study was designed as a naturalistic, Patient-Reported Outcome Measures (PROMs)-based, clinic-based, multi-center study; thirty-two child and adolescent psychiatry clinics from 26 cities located in seven geographical regions of T & uuml;rkiye were included. Clinicians evaluated ADHD symptom severity at baseline and at the end of the 6th month with Clinical Global Impressions (CGI)-Severity, Improvement, and Adverse Effect scales while parents evaluated symptoms with the DSM-IV-Based Screening Scale for Disruptive Behavior Disorders. Adverse effects after GXR treatment were determined from patient records. Dose equivalents for stimulants, antidepressants, antipsychotics, and mood stabilizers used concurrently with GXR were calculated. Univariate and bivariate analyses along with linear mixed models were used to model change. Logistic regression was used to evaluate predictors of treatment response in sensitivity analysis.Results: Five hundred and sixty-seven patients (n = 437, 77.1% male) with a mean age of 11.2 (SD = 2.8) years were enrolled. Comorbid diagnoses were common (82.4%) along with combination therapy (85.0%). GXR at a median dose of 2.0 to 3.0 mg/day was associated with improvement and the rate of adverse effects was low. GXR showed differential symptom-domain effects, with greater improvement in hyperactive-impulsive (HI) compared to inattentive (IA) symptoms. Children with comorbid autism spectrum disorder (ASD; n = 175, 30.0% of the sample) showed notable clinical improvement. Response was modified by baseline symptom severity.Conclusion: GXR may be a viable treatment option for children and adolescents with ADHD and various comorbidities among Turkish youth in real-world clinical populations, with baseline symptom severity as a potential modifier of response. The differential response favoring HI symptoms and notable effectiveness in comorbid ASD represent clinically important findings of this naturalistic, PROM-based study.