Guanfacine and secondary mania in children.

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.