Intuniv (guanfacine XR) / Shionogi, Takeda - LARVOL DELTA

Three Adult Cases of ADHD With Comorbid Tic Symptoms Successfully Treated With Guanfacine Monotherapy. (PubMed, Neuropsychopharmacol Rep) - "Here, we present three adult male patients with childhood-onset ADHD and chronic tic symptoms who showed a rapid and significant improvement in tics with low-dose extended-release guanfacine (GXR) monotherapy. These cases suggest that GXR can effectively treat both ADHD and tic symptoms in adults-a finding that has not been well documented in prior adult studies."

Journal • Monotherapy • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Movement Disorders • Pediatrics • Psychiatry • Tic Disorders • Tourette Syndrome

Guanfacine extended-release use in diagnostic diversity and symptom complexity. (PubMed, Front Child Adolesc Psychiatry) - "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."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Genetic Disorders • Psychiatry

Updates in treatment strategies in ADHD (WFSBP 2026) - "Lisdexamfetamine, a prodrug cleaved gradually by red blood cell enzymes, provides smoother pharmacokinetics and lower abuse potential due to slower peak concentrations...OROS-methylphenidate mimics twice-daily dosing through osmotic release, while transdermal methylphenidate bypasses first-pass metabolism and reduces appetite suppression. Serdexmethylphenidate and ion-exchange amphetamine preparations further improve duration and plasma stability...These mechanisms may improve emotional dysregulation and provide faster onset than atomoxetine...Investigational therapies include centanafadine, a triple DAT-NET-SERT inhibitor targeting emotional dysregulation; TAAR-1 agonists, which modulate dopamine and glutamate signaling; and metadoxine extended release, which restores GABA-glutamate balance and may preferentially benefit inattentive ADHD...DAT1 and SERT polymorphisms may predict stimulant or serotonergic treatment response, while COMT Val158Met variants influence..."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Mood Disorders • Psychiatry • Tic Disorders • Tourette Syndrome • COMT

AGUALIS: Experimental fMRI Study of Guanfacine and Lisdexamfetamine in ADHD Adolescents (clinicaltrials.gov) - P=N/A | N=25 | Completed | Sponsor: King's College London | Active, not recruiting ➔ Completed

Trial completion • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Management of Comorbid Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and Anxiety in Pediatric PMHNP Practice. (PubMed, J Psychosoc Nurs Ment Health Serv) - "For psychiatric-mental health nurse practitioners, these findings underscore the importance of individualized, family-centered care; ASD-specific assessment; and interdisciplinary collaboration. Ethical prescribing, ongoing clinical monitoring, and meaningful caregiver engagement are essential to optimizing outcomes and enhancing quality of life for children with ASD and comorbid psychiatric conditions."

Journal • Review • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Autism Spectrum Disorder • CNS Disorders • Genetic Disorders • Mood Disorders • Pediatrics • Psychiatry • Sleep Disorder

Clinical Outcomes of Extended-Release Guanfacine in Adults With Attention-Deficit/Hyperactivity Disorder: A Retrospective Chart Review. (PubMed, Cureus) - "Conclusions These findings suggest that GXR may be a clinically useful and generally well-tolerated treatment option for adults with ADHD in routine practice in Japan. The results support cautious real-world titration and highlight the need for prospective studies using standardized adult ADHD outcome measures."

Clinical data • Journal • Retrospective data • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Developmental Disorders • Mental Retardation • Psychiatry

ADHD Treatment and Skin-Picking: Help or Harm? (BAD 2026) - "Eligible publications described children or adults with diagnosed or implied ADHD treated with stimulant or nonstimulant agents (methylphenidate, amphetamine derivatives, atomoxetine, guanfacine, clonidine or bupropion), in whom BFRBs were reported as treatment outcomes or adverse effects. ADHD medications are neither uniformly therapeutic nor uniformly harmful for BFRBs; their impact appears to depend on individual vulnerability rather than drug class alone. Clinicians should treat ADHD as indicated but closely monitor for both benefit and emergent BFRBs, considering alpha-2 agonists where medication-linked behaviours arise, and remain alert to ADHD medication effects when managing BFRBs."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

ADHD Treatment and Skin-Picking: Help or Harm? (BAD 2026) - "Eligible publications described children or adults with diagnosed or implied ADHD treated with stimulant or nonstimulant agents (methylphenidate, amphetamine derivatives, atomoxetine, guanfacine, clonidine or bupropion), in whom BFRBs were reported as treatment outcomes or adverse effects. ADHD medications are neither uniformly therapeutic nor uniformly harmful for BFRBs; their impact appears to depend on individual vulnerability rather than drug class alone. Clinicians should treat ADHD as indicated but closely monitor for both benefit and emergent BFRBs, considering alpha-2 agonists where medication-linked behaviours arise, and remain alert to ADHD medication effects when managing BFRBs."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

Changes in characteristics and body mass index-SD after guanfacine extended-release administration for ADHD children. (PubMed, Fukushima J Med Sci) - "To clarify the change in characteristics and body mass index standard deviation (BMI-SD) after guanfacine extended-release (GXR) administration for attention-deficit/hyperactivity disorder (ADHD) children, we undertook a clinical survey of ADHD children. Among 209 pediatric patients with ADHD, two groups were selected:those who patients were received GXR monotherapy (Group 1) and those who were treated with non-pharmacological therapy alone (Group 2). 1) BMI-SD scores before and after treatment were 0.56±1.05, 0.76±1.21, respectively, in Group 1 and 0.33±1.18, 0.46±1.15, respectively, in Group 2. The frequency of patients with a BMI-SD score more than 2.0 SD before and at about 2 years after treatment were 7.8% and 13.7%, respectively, in Group 1 and 4.1% and 8.2%, respectively, in Group 2. There were no significant differences between these values before and after treatment. 2) ADHD Rating Scale (ADHD-RS) scores and the improvement rate for each..."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Genetic Disorders • Obesity • Pediatrics • Psychiatry

Effect of Guanfacine on Opioid-induced Hyperalgesia (OIH) and Tolerance (clinicaltrials.gov) - P4 | N=137 | Terminated | Sponsor: Massachusetts General Hospital | N=200 ➔ 137

Enrollment change • Pain

Effect of Guanfacine on the Reversal of Opioid-induced Hyperalgesia (OIH) (clinicaltrials.gov) - P=N/A | N=8 | Terminated | Sponsor: Massachusetts General Hospital | N=120 ➔ 8

Enrollment change • Pain

Challenging Case: Health Care Professionals as Cultural Brokers for a Boy From Central America With Attention-Deficit Hyperactivity Disorder and Trauma and Stressor-related Disorder. (PubMed, J Dev Behav Pediatr) - "His mother did not have prior conceptualization of developmental or psychiatric diagnoses, and psychoeducation through a cultural lens was provided. What are your next steps in partnering with Javier's family as they navigate medical and educational systems following their recent arrival to the United States?* "Javier is a pseudonym"."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Genetic Disorders • Mood Disorders • Pediatrics • Post-traumatic Stress Disorder • Psychiatry

Guanfacine for Dexmedetomidine Withdrawal (SCCM 2026) - "Historically, clonidine has been used for this purpose, however its use is limited by cardiovascular effects, namely hypotension... The results of this evaluation reveal a lack of standardized guanfacine dosing strategies in dexmedetomidine weaning, suggesting an opportunity for protocol development. Additionally, the findings suggest an education opportunity for providers on ensuring the appropriate guanfacine formulation is ordered for the planned route of administration. Immediate future directions for this project include a research project designed to evaluate the comparative efficacy of dexmedetomidine weaning strategies."

Cardiovascular • Hypotension

Mechanistic Evaluation of Guanfacine on Drinking Behavior in Women and Men With Alcohol Use Disorders (clinicaltrials.gov) - P2 | N=160 | Recruiting | Sponsor: Yale University | Trial completion date: Feb 2026 ➔ Aug 2026 | Trial primary completion date: Feb 2026 ➔ Aug 2026

Trial completion date • Trial primary completion date • Addiction (Opioid and Alcohol)

Sexual Health and Transition Needs in an Adolescent Girl With Attention-deficit Hyperactivity Disorder and Smith-magenis Syndrome. (PubMed, J Dev Behav Pediatr) - "Lucia was prescribed short-acting methylphenidate for ADHD but had trembling extremities and heard voices when on therapeutic doses. Lucia's mother is interested in gynecological counseling and potentially birth control, given concerns about Lucia's vulnerability. How would you begin to advise Lucia's family about behavioral and medication management?"

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Developmental Disorders • Long-acting Reversible Contraceptives • Mental Retardation • Mood Disorders • Otorhinolaryngology • Pain • Psychiatry • Urinary Incontinence • Urology

Differential effects of a single dose of Lisdexamfetamine and Guanfacine on cognitive function in children with ADHD. (PubMed, Front Psychiatry) - P=N/A | "Findings suggest that guanfacine, unlike lisdexamfetamine, may not improve attention in children and adolescents with ADHD. https://clinicaltrials.gov/study/NCT03333668?term=NCT03333668&rank=1#study-plan, identifier NCT03333668."

Journal • ADHD (Impulsive Aggression) • Alzheimer's Disease • Attention Deficit Hyperactivity Disorder • CNS Disorders • Cognitive Disorders • Psychiatry

Reverse Takotsubo Cardiomyopathy Caused by Repeated Guanfacine Overdose. (PubMed, JACC Case Rep) - "An overdose of guanfacine, a medication used for treating attention-deficit hyperactivity disorder, can result in reverse takotsubo cardiomyopathy in a blood concentration-dependent manner. The cardiopulmonary time course of an extended-release guanfacine overdose spans approximately 2 weeks, with early critical respiratory failure, reverse takotsubo cardiomyopathy, and late QT prolongation."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Cardiomyopathy • Cardiovascular • CNS Disorders • Psychiatry • Respiratory Diseases

Effect of Guanfacine on the Reversal of Opioid-induced Hyperalgesia (OIH) (clinicaltrials.gov) - P=N/A | N=120 | Terminated | Sponsor: Massachusetts General Hospital | Active, not recruiting ➔ Terminated; End of NIH funding

Trial termination • Pain

Effect of Guanfacine on Opioid-induced Hyperalgesia (OIH) and Tolerance (clinicaltrials.gov) - P4 | N=200 | Terminated | Sponsor: Massachusetts General Hospital | Active, not recruiting ➔ Terminated; End of NIH funding

Trial termination • Pain

Guanfacine use in diagnostic diversity and symptom complexity (ECNP 2025) - "Extended-release guanfacine significantly reduced ADHD symptoms and improved daily functioning, with most children tolerating treatment well. Somnolence and headache occurred in 10–15% of cases but were generally mild and transient; no meaningful cardiac effects emerged. While longer-term data beyond 12 months remain scarce, these findings support guanfacine's role in enhancing executive control via alpha-2 adrenergic modulation."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Cognitive Disorders • Mental Retardation • Mood Disorders • Psychiatry

Combined guanfacine and methylphenidate treatment in a child with autism spectrum disorder and attention-deficit/hyperactivity disorder: A case report (ECNP 2025) - "Extended-release guanfacine may be considered as a treatment option with methylphenidate or without methylphenidate, particularly in cases of ASD with comorbid ADHD who shows a lack of adequate responds to psychostimulants or who present with accompanying symptoms such as irritability. Better symptom control without adverse effects was achieved by gradual titration and careful observation. Combination treatment may be a valuable approach in managing complex cases with overlapping neurodevelopmental symptoms."

Case report • Clinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Guanfacine for Alcohol Use Disorder (AUD) (clinicaltrials.gov) - P2 | N=200 | Recruiting | Sponsor: Indiana University | Not yet recruiting ➔ Recruiting

Enrollment open • Addiction (Opioid and Alcohol)

A Study of TAK-503 in Children and Teenagers With Attention Deficit Hyperactivity Disorder (ADHD) (clinicaltrials.gov) - P4 | N=396 | Completed | Sponsor: Shire | Active, not recruiting ➔ Completed

Trial completion • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

A Study of TAK-503 in Children and Teenagers With Attention Deficit Hyperactivity Disorder (ADHD) (clinicaltrials.gov) - P4 | N=397 | Active, not recruiting | Sponsor: Shire | N=288 ➔ 397 | Trial completion date: Jun 2027 ➔ Aug 2025 | Trial primary completion date: Jun 2027 ➔ Aug 2025

Enrollment change • Trial completion date • Trial primary completion date • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Combining Varenicline and Guanfacine for Smoking Cessation (clinicaltrials.gov) - P2 | N=165 | Completed | Sponsor: Yale University | Recruiting ➔ Completed | Trial completion date: Jul 2026 ➔ Apr 2025 | Trial primary completion date: Jul 2026 ➔ Apr 2025

Trial completion • Trial completion date • Trial primary completion date • Tobacco Cessation