An Open-Label, Prospective Study of Guanfacine in Children with ADHD and Tic Disorders
Vitharon Boon-yasidhi MD*, Young S. Kim MD**, Lawrence Scahill MSN, PhD**
Affiliation : * Division of Child Psychiatry, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand ** Yale Child Study Center, Yale University, New Haven, CT, USA
Objectives : To evaluate the efficacy and safety of guanfacine in children with attention-deficit hyperactivity
disorder (ADHD) and tic disorders.
Materials and Methods : Twenty-five medication-free subjects (23 males and 2 females), aged 7-16
(mean=10.6+2.0) years participated in an 8-week open-label guanfacine study. Subjects were recruited from
a specialty clinic for children with tic disorders over a four-year period. Eligibility criteria included presence
of ADHD (any type), a tic disorder (any type), and being medication free for two weeks. Outcome measures
included the Hyperactivity Index of the Conners Parent Questionnaire, the teacher-rated ADHD Rating Scale,
and the Yale Global Tic Severity Scale (YGTSS).
Results : All subjects met criteria for ADHD (combined type N=22; predominantly inattentive type N=3) and
a tic disorder (Touretteûs Disorder N=20; chronic motor tic disorder N=5). At an average dose of 2.0 + 0.6 mg/
day, guanfacine was associated with mean improvement of 27% on the Hyperactivity Index (N=25; t=4.61;
p<0.001), 32% on the total score of the teacher-rated ADHD Scale (N=19; t=5.27; p<0.001), and 39% on the
total tic severity scale (N=19; t=4.17; p<0.001). Mild and statistically insignificant decreases in blood
pressure and pulse were observed in the sample as a whole. Five subjects had endpoint systolic blood pressure
below 1 SD from their age and gender norms.
Conclusion : Results of this open-label study add to the growing
data base on the safety and efficacy of guanfacine in children with ADHD and tic disorders.
Keywords : Guanfacine, Attention-deficit hyperactivity disorder, Tic disorders, Children
