Thursday, January 10, 2008

Guanfacine XR Is Effective and Improves Adherence with ADHD

This is just the first couple of paragraphs from a MedScape story I read. I always find it sad when children are prescribed meds for mental instabilities. But we do live in a medicated world and pills fix problems. As I always say, anything that improves adherence works for me, but check out my comments at the end.

I went to high school and college with kids who were diagnosed ADHD and took Ritalin. I never really understood why. I mean isn't concentration something you learn in grammar school? Would any child choose to focus on their school work unless they were taught how to do so?

You don't automatically know how to study or prepare for an exam or write a term paper without learning how to do it. I guess when you call a kid spaz and they have some energy, you should just medicate. I really am not looking forward to seeing what happens to my son in a few years when he starts to act up and the psychologist recommends putting him on medication.

There is more technical information at MedScape, but it is not relevant to my comments.

January 9, 2008 — Guanfacine extended release (Shire Inc.) at doses of 2, 3, and 4 mg/day was effective vs placebo and was generally well tolerated in a multicenter, 8-week, fixed-dose escalation study in children aged 6 to 17 years old with attention-deficit/hyperactivity disorder (ADHD).

The study, part of a new drug application, is published in the January issue of Pediatrics.

"I think it is very important for clinicians and families to have alternative treat a condition in which many patients cannot tolerate or do not respond to treatment," lead author, Joseph Biederman, MD, from Massachusetts General Hospital in Boston, told Medscape Psychiatry, adding that guanfacine extended release offers a unique option for patients who do not do well taking other treatments.

Any Stimulant Is Ineffective for 1 in 4 Patients

ADHD is a very prevalent, very morbid disorder, said Dr. Biederman. Although stimulants are the mainstay of treatment, any 1 stimulant is ineffective in 25% to 30% of cases, the group writes.

Guanfacine extended release, a nonstimulant, is an alpha-2 adrenergic agonist like clonidine (Catapres; Boehringer-Ingelheim) but is more selective. Both of these drugs came to market as antihypertensive agents, said Dr. Biederman, adding that they have been used off label in psychiatry for many years for managing withdrawal reactions, treating severe hyperactivity in ADHD, and, more recently, treating insomnia that frequently develops as a consequence of stimulant treatment.

The study aimed to assess the efficacy and safety of guanfacine extended release for the treatment of children and adolescents with ADHD.

The trail was conducted in 48 centers in the United States. Patients aged 6 to 17 years old who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for ADHD were eligible to participate.


Did you read what Guanfacine came on to the market for? Did you read what it was prescribed off label for? These really disturb me that all of a sudden, hey, lets give it to kids who are too stimulated already! I do not know that much about medicine or science, but I would assume that there is a large gap between hypertension and ADHD.

Maybe I am wrong.

When a junkie goes through withdrawal, uh, I guess it is just like a hyperactive child - this sort of makes sense to me with frazzled nerves and brain functions. Also insomnia? I know that for people who do not suffer from ADHD, taking medications that are prescribed for ADHD makes them speedy, but puts them to sleep?

I need to learn more to properly comment on these items, but this is what I thought when I read it.

Stay adherent!

1 comment:

Anonymous said...

I just read the article on Guanfacine and the author was quite harsh in his/her opinion on the use of meds. for kids, I guarantee he/she doens't live day in and day out with a kid with a chronic mood disorder. I bet he/she hasn't tried every parenting technique out there and surrounded his/her child with love and comfort, tough love, rewards and boundries for 6 long years
(and our kid is only 11), has he/she been to drs. and counselors and researched all meds. for side effects,etc and still was scared to try a new one, but hearing my kid say, " I don't want to feel like this anymore" makes me think again. You can't teach a kid to be "happy" or just snap out of it.. Maybe the author doesn't live in a home where there child is chronically irritable, anxious, aggitated and moody, to where it is like living with a alcoholic..( imagine the siblings)but we keep going. Maybe the author doesn't realize that when both grandpas have had mood disorders that genetically 1 out of 3 of the offspring may get it YES...meds. are needed and some things can't just be "taught" in the classroom, like you said...come to my house day after day..and see if you still think MEds. aren't the answer in conjunction with other options.