G628 A retrospective study to understand emerging themes from using long acting guanfacine – non stimulant medication in 70 children and young people with adhd (attention deficit hyperactivity disorder) in a secondary care setting

Aims

As most clinicians have limited experience and are still not confident about using Guanfacine since its license in 2016 in Uk, this study was undertaken to identify any emerging themes-any gender differences, comorbid factros and side effects whihc could impact on its usage.

Method

Data was collected from clinical notes on all our patients on Guanfacine over the past one year. This study looked at demographics, co morbidity, tolerance and dosage needed. Emerging themes were identified in addition which could inform future studies on use of Guanfacine.

Results

Age range 4–15 years (12 girls and 58 boys) received treatment with Guanfacine. Comorbidity was seen in 48 patients (69%): Autism spectrum disorder was commonest (16), Developmental coordination disorder (13), Leaning disability (10) some had other conditions e.g. Conduct disorder, tic disorder, dyslexia. Guanfacine was discontinued in 36 patients (51%), the commonset side effect was sedation in 20 patients (29%) and other reasons for discontinuation included headaches, aggressive behaviour and ineffective control of ADHD symptoms. The success rate was 98.8% in teenage girls. The dose range was 1 mg (19) to 6 mg (1), and most patients (36) needed 2 to 3 mg for effective control of symptoms.

Conclusion

It is small observational study and would be useful to have larger studies comparing the side effects and efficacy of low dose Guanfaicne in teenage girls specifically across different regions.

Recommendations

Low dose polytherapy regimes along with stimulant medication which would minimise side effects and improve overall efficacy should be explored in UK as is proven to be effective in other countries.