Guanfacine Treatment of Comorbid Attention-Deficit Hyperactivity Disorder and Tourette's Syndrome: Preliminary Clinical Experience

PHILLIP B. CHAPPELL, MARK A. RIDDLE, LAWRENCE SCAHILL, KIMBERLY A. LYNCH, ROBERT SCHULTZ, AMY ARNSTEN, JAMES F. LECKMAN, DONALD J. COHEN

Research output: Contribution to journalArticlepeer-review

Abstract

Many children with Tourette's syndrome (TS) are handicapped more by difficulties with inattention, impulsivity, and hyperactivity than by their tics. However, stimulant medications used to treat attention-deficit hyperactivity disorder (ADHD) can exacerbate tics. Guanfacine is an α-adrenergic agonist that may have beneficial effects on attention, without the hypotensive or sedative effects of clonidine, which is often used as an alternative to stimulants. Method: An open-label study of guanfacine was performed in 10 children with TS+ADHD, aged 8 to 16 years. The duration of follow-up was 4 to 20 weeks, and the majority of subjects were treated with 1.5 mg/day. Ratings of tic severity and ADHD symptoms were obtained using the Yale Global Tic Severity Scale (YGTSS), the Tic Symptom Self Report (TSSR), and the Conners Parent Rating Scale. In addition, blind Continuous Performance Tests (CPTs) were performed at baseline and at two follow-up intervals in eight subjects. Guanfacine was associated with significant decreases in both commission errors (p < .02) and omission errors (p < .01) on the CPT. In addition, guanfacine caused a significant decrease in severity of motor (p < .02) and phonic (p < .02) tics as measured by the TSSR and the YGTSS, respectively. The most common side effects were transient sedation and headaches. Conclusion: Guanfacine may provide a safe alternative therapy for children with ADHD in the presence of tics. Future double-blind, controlled trials should be undertaken. J. Am. Acad. Child Adolesc. Psychiatry, 1995, 34, 9:1140–1146.

Original languageEnglish (US)
Pages (from-to)1140-1146
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume34
Issue number9
DOIs
StatePublished - 1995
Externally publishedYes

Keywords

  • Tourette's syndrome
  • attention-deficit hyperactivity disorder
  • guanfacine

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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