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Guanfacine and secondary mania in children
1Division of Child Psychiatry, UNC Hospitals, Chapel Hill 27599-7160, USA. jhorrigan@css.unc.edu
Introduction:
Guanfacine hydrochloride is an alpha-2 adrenergic agonist, which has gained recent attention in the field of child and adolescent psychiatry. This medication has been described as effective in the management of attention-deficit hyperactivity and tic disorders, with minimal side effects.
Methods:
Presented here are five cases of behavioral activation in children treated with guanfacine.
Results:
In each instance the clinical presentation resembled an acute hypomanic or manic episode. The dose of guanfacine was 0.5 mg/day. Later investigation revealed that all of the youngsters had clear risk factors (clinical and/or familial) for bipolar disorder.
Conclusions:
It appears as though guanfacine may be capable of precipitating secondary mania in vulnerable children.