Combination Therapy Shows Positive Response for Children with ADHD

Reports new study in Journal of the American Academy of Child and Adolescent Psychiatry

Washington D.C., January 9, 2012- While pharmacologic agents have a demonstrated efficacy in children with Attention-deficit/hyperactivity disorder (ADHD), some children have suboptimal response to a single pharmacologic agent. A recent study by Dr. Timothy E. Wilens and colleagues, published in the January 2012 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), is the first randomized placebo-controlled trial designed to assess efficacy and safety of guanfacine extended release (GXR) as an adjunct to psychostimulants in children and adolescents diagnosed with ADHD who had a suboptimal response to a psychostimulant alone.

As reported in the article “A Controlled Trial of Extended-release Guanfacine and Psychostimulants for Attention-deficit/hyperactivity disorder,” Wilens and colleagues conducted a nine week multicenter, double-blind, placebo-controlled, dose-optimization study, with participants in 59 study sites who continued their stable dose of psychostimulant given in the morning 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. In particular, the inattention subscale rating and the hyperactivity/ impulsivity subscales of the ADHD-RS-IV showed significantly greater improvements from baseline in subjects receiving GXR with a psychostimulant compared with subjects receiving placebo plus psychostimulant. Significant benefits of adjunctive administration were observed whether GXR was administered in the morning or evening. No new safety signals emerged after adjunctive administration of GXR with psychostimulants compared with psychostimulants alone.

Reflecting on their research findings, Wilens and colleagues stated, “The results of this study support the hypothesis that adjunctive administration of the selective alpha2A-adrenoceptoragonist, GXR, to a psychostimulant in subjects with suboptimal response to psychostimulants reduces ADHD symptoms over placebo with a psychostimulant.”

The article is “A Controlled Trial of Extended-release Guanfacine and Psychostimulants for Attention-deficit/hyperactivity disorder” by Timothy E. Wilens, Oscar Bukstein, Matthew Brams, Andrew J. Cutler, Ann Childress, Thomas Rugino, Andrew Lyne, Kara Grannis, Sharon Youcha (doi:10.1016/j.jaac.2011.10.012). The article appears in Journal of the American Academy of Child and Adolescent Psychiatry, Volume 51, Issue 1 (January 2012), published by Elsevier.

This study was supported by Shire Development Inc., Wayne, PA.

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Notes for editors
Full text of the article is available to credentialed journalists upon request; contact Mary Billingsley at +1 202 966 7300 x105 or mbillingsley@jaacap.org. Journalists wishing to interview the authors may contact Dr. Timothy E. Wilens at twilens@partners.org.

About JAACAP
Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.


About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

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Media contact

Mary Billingsley
Editorial Office JAACAP
+1 202 966 7300 x105
mbillingsley@jaacap.org