New research investigates the benefit of adding an additional drug for children who have displayed a suboptimal response to traditional attention-deficit hyperactivity (ADHD) medication.
In the study, Timothy E. Wilens, M.D., and colleagues assessed the efficacy and safety of guanfacine extended release (GXR, also known by its brand name, Intuniv) as an adjunct to psychostimulants (such as Ritalin) in children and adolescents diagnosed with ADHD who did not respond fully to a psychostimulant alone.
The study is the first randomized placebo-controlled trial of this approach and the findings are published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
Researchers conducted a nine-week multicenter, double-blind, placebo-controlled, dose-optimization study, with participants in 59 study sites. Participants continued their morning dose of psychostimulant and were randomized to receive GXR in the morning, GXR in the evening, or placebo.
For both morning and evening administration of GXR, subjects receiving GXR plus a psychostimulant showed significantly greater improvement from baseline to endpoint, as measured by the ADHD-Rating Scale IV total score, compared with subjects receiving placebo plus a psychostimulant.
Researchers found the inattention subscale rating and the hyperactivity/ impulsivity subscales of the scale showed significantly greater improvements from baseline in subjects receiving GXR with a psychostimulant.
Investigators discovered the administration of GXR in the morning or evening produced significant beneficial results. Additional side effects were not detected after the adjunctive administration of GXR with psychostimulants compared with psychostimulants alone.
Researchers say the findings support the adjunctive administration of the selective alpha2A-adrenoceptoragonist, GXR, to individuals who do not respond to a psychostimulant.