Guanfacine and secondary mania in children

Introduction: Guanfacine hydrochloride is an alpha-2 adrenergic agonist, wh ich has gained recent attention in the field of child and adolescent psychi atry. This medication has been described as effective in the management of attention-deficit hyperactivity and tic disorders, with minimal side effect s. Methods: Presented here are five cases of behavioral activation in child ren treated with guanfacine. Results: In each instance the clinical present ation resembled an acute hypomanic or manic episode. The dose of guanfacine was 0.5 mg/day. Later investigation revealed that all of the youngsters ha d clear risk factors (clinical and/or familial) for bipolar disorder. Concl usions: It appears as though guanfacine may be capable of precipitating sec ondary mania in vulnerable children. (C) 1999 Elsevier Science B.V. All rig hts reserved.