Guanfacine Hydrochloride Extended-Release for the Treatment of Attention Deficit Hyperactivity Disorder in Adults: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Key Message

Limited evidence from a single randomized controlled trial suggested that guanfacine hydrochloride extended-release (GXR) was safe and well-tolerated when added to an existing psychostimulant treatment for adults with attention deficit hyperactivity disorder (ADHD). However, GXR did not differ from placebo with respect to clinical effectiveness. No evidence for the cost-effectiveness of GXR for the treatment of adults with ADHD was identified. One evidence-based guideline from the United Kingdom was identified that provides recommendations regarding the use of GXR in the management of ADHD in adults. Based on predominantly low- to moderate-quality evidence, the guideline provides a strong recommendation against the use of guanfacine (immediate or extended-release preparation not specified) in adults without advice from a tertiary ADHD service. Further, if a person taking guanfacine experiences sustained orthostatic hypotension or fainting episodes, the guideline recommends reducing the dose or switching to another ADHD medication.