Keywords
ADHD
children
adolescents
pharmacotherapy
Abstract
Guanfacine extended-release (XR) has emerged as an important non-stimulant therapeutic option for the management of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, particularly in cases characterized by inattention, impulsivity, and sleep-related difficulties. Evidence from randomized controlled trials as well as long-term observational studies consistently demonstrates clinically meaningful improvements with guanfacine XR, both when used as monotherapy and in combination with stimulant medications. Through its selective α2A-adrenergic receptor agonism, guanfacine XR modulates prefrontal cortical networks, thereby enhancing executive functioning and supporting behavioral regulation. Although sedation is frequently reported during the early stages of treatment, this effect generally subsides with continued use, and several studies suggest potential benefits for sleep continuity. Importantly, clinical investigations indicate that guanfacine XR provides effective symptom control without impairing cognitive performance, with additional advantages observed in some cases when used adjunctively with stimulants. In Turkey, guanfacine XR is available under the trade names Arislow® and Guago®. Despite international guideline recommendations highlighting its role as a non-stimulant treatment alternative, evidence from local clinical practice remains scarce. Ongoing research is needed to further elucidate its long-term efficacy and safety profile in diverse populations. Additionally, increased awareness and training among healthcare providers in Turkey could enhance its utilization in clinical settings.
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