G626 Use of long acting guanfacine in adhd and assessing the comorbidity and parents’ perceptions

Aims A study was conducted to find out the clinical indications, prior stimulant use, associated comorbidity and parents/carers’ perceptions on the use of long acting guanfacine in children and adolescents with ADHD. Methods The number of patients with ADHD on guanfacine over a period of 9 months were identified through IT support and their clinical records were accessed from our electronic system. Parents/carers’ comments were also noted in relation to their child’s progress. Results 22 patients (17 boys and 5 girls) aged 7–16 years were commenced on guanfacine, with 50% aged 13 years and above. All the patients had one or more associated comorbid conditions varying from sleep problems (50%), autism spectrum disorder (40.9%), anxiety (18%), oppositional defiant behaviour (18%), learning disability (9%) and sensory processing problems (4.5%). 21 patients previously received various formulations of either methylphenidate or amphetamine medications. However, one patient with a diagnosis of William’s syndrome with cardiac problems was commenced on guanfacine as the 1st option, following recommendation from a cardiologist. In 19 patients (86.3%) the stimulant medication was not found to be effective, not tolerated in 2 patients (9%) and not suitable in 1 patient (4.5%). The stable/maintenance dose of guanfacine was noted to be 1 mg for 5 patients (22.7%), 2 mg for 9 patients (40.9%), 3 mg for 6 patients (27.2%) and 5 mg for 2 patients (9%). Towards clinical outcomes, 14 parents/carers (63.6%) provided comments such as the child/adolescent is less aggressive, good symptom control, sleeping better, good start to school, best medication so far, much calmer and ‘it is absolutely amazing!’ Conclusion Our study revealed that long acting guanfacine can be useful when the stimulant medication is not effective, not tolerated or not suitable. This complies with the current NICE guidelines. Despite a significant comorbidity, a high level of parents/carers’ satisfaction is noted in our group.