Research Article
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Çocuk ve Ergenlerde Dikkat Eksikliği ve Hiperaktivite Bozukluğunun Yönetiminde Guanfasin: Bir Türkiye Polikliniğinden Bulgular

Year 2025, Volume: 78 Issue: 4, 313 - 319, 31.12.2025
https://doi.org/10.65092/autfm.1719404

Abstract

Amaç: Bu kısa rapor, çocuk psikiyatrisi polikliniğimizde dikkat eksikliği/hiperaktivite bozukluğu (DEHB) tanısı almış ve uzatılmış salınımlı (ER) guanfasin reçete edilmiş Türk çocuk ve ergenlerin tedavi sürecine dair deneyimlerimizi özetlemeyi amaçlamaktadır.
Yöntem: Veriler, DEHB tanısı almış ve ER guanfasin kullanmış çocuk ve ergen hastaların hasta kayıtlarının geriye dönük olarak incelenmesiyle elde edilmiştir.
Bulgular: Yaşları 8 ile 17 arasında değişen 23 hastanın (18 erkek, 5 kız) klinik verileri analiz edilmiştir. Çalışmada hastaların demografik özellikleri, gelişimsel değerlendirmeleri, eşlik eden ek psikiyatrik tanılar, başvuru şikayetleri, önceki tedavi öyküleri, başlangıçtaki tedavi yanıtları ve yan etkileri, guanfasin tedavisine başlama veya mevcut tedaviye eklenme endikasyonları, tedavi sonuçları ve guanfasin ile ilişkili yan etkiler ile gerektiğinde tedavinin kesilme nedenleri incelenmiştir.
Sonuç: Bu ön rapor, guanfasinin DEHB tedavisinde iyi tolere edildiğini, güvenli ve etkili olduğunu göstermektedir. Guanfasinin, DEHB semptomlarını hafifletmenin yanı sıra, irritabilite, karşıt olma-karşı gelme davranışları, agresif davranışlar ve tikleri azaltmada da etkili olduğu görülmüştür. Özellikle DEHB’ye eşlik eden birden fazla nörogelişimsel bozukluğu olan çocuklarda olumlu sonuçlar gözlemlenmiştir.

References

  • Amer YS, Al-Joudi HF, Varnham JL, et al. Appraisal of Clinical Practice Guidelines for the Management of Attention Deficit Hyperactivity Disorder (ADHD) Using the AGREE II Instrument: A Systematic Review. PLoS One 2019;14(7):e0219239.
  • Baker M, Huefner JC, Bellonci C, et al. Polypharmacy in the Management of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Review and Update. J Child Adolesc Psychopharmacol 2021;31(3):148–163.
  • Biederman J, Melmed RD, Patel A, et al. A Randomized, Double-Blind, Placebo-Controlled Study of Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Pediatrics 2008;121(1):e73–e84.
  • Canadian A. Resource Alliance (CADDRA): Canadian ADHD Practice Guidelines, Toronto ON; CADDRA, 2018. 2021.
  • Cruz MP. Guanfacine Extended-Release Tablets (Intuniv), a Nonstimulant Selective Alpha2a-Adrenergic Receptor Agonist for Attention-Deficit/Hyperactivity Disorder. Pharm Ther 2010;35(8):448.
  • Ercan ES, Polanczyk G, Akyol Ardıc U, et al. The Prevalence of Childhood Psychopathology in Turkey: A Cross-Sectional Multicenter Nationwide Study (EPICPAT-T). Nord J Psychiatry 2019;73(2):132–140.
  • Horrigan JP and Barnhill LJ. Guanfacine for Treatment of Attention-Deficit Hyperactivity Disorder in Boys. J Child Adolesc Psychopharmacol 1995;5(3):215–223.
  • Işık Ü, Öğütlü H, Kutuk MÖ, et al. The Role of Long-Acting Guanfasine in the Treatment of Attention Deficit Hyperactivity Disorder. Turk J Child Adolesc Ment Heal 2023;30(1):20–27.
  • Loo SK, Bilder RM, Cho AL, et al. Effects of D-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2016;55(8):674–682.
  • McCracken JT, McGough JJ, Loo SK, et al. Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study. J Am Acad Child Adolesc Psychiatry 2016;55(8):657–666.
  • Newcorn JH, Huss M, Connor DF, et al. Efficacy of Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder. J Dev Behav Pediatr 2020;41(7):565–570.
  • Öğütlü H, Kütük ÖM, Tufan AE, et al. The Detect Consensus Report on Attention Deficit/Hyperactivity Disorder and Its Management among Turkish Children and Adolescents (Detect: Consensus Report on ADHD among Turkish Youth). Front Psychiatry 2024;15:1372341.
  • Park HN, Kong NY, Kim H-C, et al. Effectiveness and Tolerability of Combination Pharmacotherapy With Stimulant and Non-Stimulant in Children With Attention Deficit Hyperactivity Disorder. J Korean Acad Child Adolesc Psychiatry 2024;35(1):82.
  • Polanczyk G, De Lima MS, Horta BL, et al. The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis. Am J Psychiatry 2007;164(6):942–948.
  • Sallee FR, Mcgough J, Wigal T, et al. Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Placebo-Controlled Trial. J Am Acad Child Adolesc Psychiatry 2009;48(2):155–165.
  • Scahill L, McCracken JT, King BH, et al. Extended-Release Guanfacine for Hyperactivity in Children with Autism Spectrum Disorder. Am J Psychiatry 2015;172(12):1197–1206.
  • Temeltürk RD, Ekici Gİ, Efendi GY, et al. Use of Clonidine in Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder Comorbidity: Report of 3 Cases. Psychiatry Clin Psychopharmacol 2023;33(4):326.
  • Wilens TE, Robertson B, Sikirica V, et al. A Randomized, Placebo-Controlled Trial of Guanfacine Extended Release in Adolescents with Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2015;54(11):916–925.
  • Yu S, Shen S and Tao M. Guanfacine for the Treatment of Attention-Deficit Hyperactivity Disorder: An Updated Systematic Review and Meta-Analysis. J Child Adolesc Psychopharmacol 2023;33(2):40–50.

Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic

Year 2025, Volume: 78 Issue: 4, 313 - 319, 31.12.2025
https://doi.org/10.65092/autfm.1719404

Abstract

Objective: This brief report aims to summarize our outpatient child psychiatry clinic’s experience regarding extended release (ER) guanfacine use in the help-seeking Turkish Attention Deficit/Hyperactivity Disorder (ADHD) children and adolescents.
Methods: Data were gathered through a retrospective review of patient records from our database, focusing on children and adolescents diagnosed with ADHD who had been prescribed ER guanfacine.
Results: The clinical data of 23 patients (18 males and 5 females) aged 8 to 17 years were analyzed, focusing on their demographic characteristics, developmental assessments, comorbid psychiatric diagnoses, initial psychiatric complaints, history of previous treatments, initial treatment responses and side effects, indications for initiating or augmenting treatment with guanfacine, therapeutic outcomes, and adverse effects associated with guanfacine, and the reasons for discontinuation when applicable.
Conclusion: This preliminary report suggests that guanfacine is well-tolerated, safe, and effective in alleviating ADHD-related symptoms, as well as reducing irritability, oppositional defiance, aggressive behaviors, and tics in children with ADHD comorbid multiple neurodevelopmental disorders.

Ethical Statement

Ethics approval was obtained from the Human Research Ethics Committee of Ankara University Faculty of Medicine (Approval number: İ09-721-24).

References

  • Amer YS, Al-Joudi HF, Varnham JL, et al. Appraisal of Clinical Practice Guidelines for the Management of Attention Deficit Hyperactivity Disorder (ADHD) Using the AGREE II Instrument: A Systematic Review. PLoS One 2019;14(7):e0219239.
  • Baker M, Huefner JC, Bellonci C, et al. Polypharmacy in the Management of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Review and Update. J Child Adolesc Psychopharmacol 2021;31(3):148–163.
  • Biederman J, Melmed RD, Patel A, et al. A Randomized, Double-Blind, Placebo-Controlled Study of Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Pediatrics 2008;121(1):e73–e84.
  • Canadian A. Resource Alliance (CADDRA): Canadian ADHD Practice Guidelines, Toronto ON; CADDRA, 2018. 2021.
  • Cruz MP. Guanfacine Extended-Release Tablets (Intuniv), a Nonstimulant Selective Alpha2a-Adrenergic Receptor Agonist for Attention-Deficit/Hyperactivity Disorder. Pharm Ther 2010;35(8):448.
  • Ercan ES, Polanczyk G, Akyol Ardıc U, et al. The Prevalence of Childhood Psychopathology in Turkey: A Cross-Sectional Multicenter Nationwide Study (EPICPAT-T). Nord J Psychiatry 2019;73(2):132–140.
  • Horrigan JP and Barnhill LJ. Guanfacine for Treatment of Attention-Deficit Hyperactivity Disorder in Boys. J Child Adolesc Psychopharmacol 1995;5(3):215–223.
  • Işık Ü, Öğütlü H, Kutuk MÖ, et al. The Role of Long-Acting Guanfasine in the Treatment of Attention Deficit Hyperactivity Disorder. Turk J Child Adolesc Ment Heal 2023;30(1):20–27.
  • Loo SK, Bilder RM, Cho AL, et al. Effects of D-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2016;55(8):674–682.
  • McCracken JT, McGough JJ, Loo SK, et al. Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study. J Am Acad Child Adolesc Psychiatry 2016;55(8):657–666.
  • Newcorn JH, Huss M, Connor DF, et al. Efficacy of Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder. J Dev Behav Pediatr 2020;41(7):565–570.
  • Öğütlü H, Kütük ÖM, Tufan AE, et al. The Detect Consensus Report on Attention Deficit/Hyperactivity Disorder and Its Management among Turkish Children and Adolescents (Detect: Consensus Report on ADHD among Turkish Youth). Front Psychiatry 2024;15:1372341.
  • Park HN, Kong NY, Kim H-C, et al. Effectiveness and Tolerability of Combination Pharmacotherapy With Stimulant and Non-Stimulant in Children With Attention Deficit Hyperactivity Disorder. J Korean Acad Child Adolesc Psychiatry 2024;35(1):82.
  • Polanczyk G, De Lima MS, Horta BL, et al. The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis. Am J Psychiatry 2007;164(6):942–948.
  • Sallee FR, Mcgough J, Wigal T, et al. Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Placebo-Controlled Trial. J Am Acad Child Adolesc Psychiatry 2009;48(2):155–165.
  • Scahill L, McCracken JT, King BH, et al. Extended-Release Guanfacine for Hyperactivity in Children with Autism Spectrum Disorder. Am J Psychiatry 2015;172(12):1197–1206.
  • Temeltürk RD, Ekici Gİ, Efendi GY, et al. Use of Clonidine in Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder Comorbidity: Report of 3 Cases. Psychiatry Clin Psychopharmacol 2023;33(4):326.
  • Wilens TE, Robertson B, Sikirica V, et al. A Randomized, Placebo-Controlled Trial of Guanfacine Extended Release in Adolescents with Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2015;54(11):916–925.
  • Yu S, Shen S and Tao M. Guanfacine for the Treatment of Attention-Deficit Hyperactivity Disorder: An Updated Systematic Review and Meta-Analysis. J Child Adolesc Psychopharmacol 2023;33(2):40–50.
There are 19 citations in total.

Details

Primary Language English
Subjects Child and Adolescent Psychiatry
Journal Section Research Article
Authors

Berat Merih Yetim 0000-0001-5185-8718

Rahime Duygu Temeltürk 0000-0002-9303-5944

Esma Kara 0009-0008-7801-8928

Müge Çakıroğlu 0000-0002-7567-6641

Sadettin Burak Açıkel 0000-0002-8964-9513

Submission Date June 13, 2025
Acceptance Date October 12, 2025
Publication Date December 31, 2025
Published in Issue Year 2025 Volume: 78 Issue: 4

Cite

APA Yetim, B. M., Temeltürk, R. D., Kara, E., … Çakıroğlu, M. (2025). Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 78(4), 313-319. https://doi.org/10.65092/autfm.1719404
AMA Yetim BM, Temeltürk RD, Kara E, Çakıroğlu M, Açıkel SB. Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic. Ankara Üniversitesi Tıp Fakültesi Mecmuası. December 2025;78(4):313-319. doi:10.65092/autfm.1719404
Chicago Yetim, Berat Merih, Rahime Duygu Temeltürk, Esma Kara, Müge Çakıroğlu, and Sadettin Burak Açıkel. “Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78, no. 4 (December 2025): 313-19. https://doi.org/10.65092/autfm.1719404.
EndNote Yetim BM, Temeltürk RD, Kara E, Çakıroğlu M, Açıkel SB (December 1, 2025) Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78 4 313–319.
IEEE B. M. Yetim, R. D. Temeltürk, E. Kara, M. Çakıroğlu, and S. B. Açıkel, “Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 78, no. 4, pp. 313–319, 2025, doi: 10.65092/autfm.1719404.
ISNAD Yetim, Berat Merih et al. “Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78/4 (December2025), 313-319. https://doi.org/10.65092/autfm.1719404.
JAMA Yetim BM, Temeltürk RD, Kara E, Çakıroğlu M, Açıkel SB. Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2025;78:313–319.
MLA Yetim, Berat Merih et al. “Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 78, no. 4, 2025, pp. 313-9, doi:10.65092/autfm.1719404.
Vancouver Yetim BM, Temeltürk RD, Kara E, Çakıroğlu M, Açıkel SB. Guanfacine in the Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Insights from a Turkish Outpatient Clinic. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2025;78(4):313-9.