A recent open-label pilot study was conducted investigating the tolerability and effectiveness of guanfacine XR (GXR) for children and adolescents with trauma symptoms, including re-experiencing, avoidance, and hyperarousal. (This study was sponsored by Shire Pharmaceuticals, the makers of Intuniv, a branded version of guanfacine.)

Seventeen subjects were enrolled, having been recruited through psychiatrists’ offices, advertisements,or word of mouth. Inclusion criteria included being six to 18 years old, having trauma symptoms as measured by standard rating instruments, and being free of other psychotropic medications.

Children were allowed to have comorbid conditions, and many did: 89.5% met criteria for ADHD, 68.4% for PTSD, 47.4% for GAD, 21.1% for depression, 10.6% for separation anxiety disorder, and 5.3% for reactive attachment disorder.

Subjects were started on 1 mg of GXR at bedtime during week one, which was titrated as needed by 1 mg weeklyto maximum dose of 4 mg/day by week five. Thirteen of the original 17 children completed the trial, with an average does of GXR of 1.19 mg/day over the course of the 8 week trial. Four dropped out due to worsening depression, side effects (sedation/fatigue), lack of effectiveness, and transportation issues.