GUANFACINE IN THE TREATMENT OF ATTENTION – DEFICIT/HYPERACTIVITY DISORDER: MECHANISMS, CLINICAL EVIDENCE AND THERAPEUTIC IMPLICATIONS

Natalia Kita; Patrycja Broniszewska; Marta Kamrowska; Jakub Świech; Filip  Kopacki; Katarzyna Apanasewicz; Weronika Szczeblewska; Daniel Jaskot; Jakub Marzec; Natalia Sztenc

doi:10.31435/ijitss.2(50).2026.5501

Authors

Natalia Kita University Clinical Hospital No. 2, Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0001-2277-6198
Patrycja Broniszewska University Clinical Hospital No. 2, Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0000-6577-307X
Marta Kamrowska University Clinical Hospital No. 2, Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0001-1570-0144
Jakub Świech University Clinical Hospital No. 2, Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0001-1732-4162
Filip Kopacki University Clinical Hospital No. 2, Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0005-7897-8222
Katarzyna Apanasewicz J. Strus Multidisciplinary Municipal Hospital in Poznań, Poland https://orcid.org/0009-0001-0765-5398
Weronika Szczeblewska Independent Public Provincial Integrated Hospital in Szczecin, Poland https://orcid.org/0009-0007-3956-622X
Daniel Jaskot Independent Public Provincial Integrated Hospital in Szczecin, Poland https://orcid.org/0009-0004-8678-9838
Jakub Marzec University Clinical Hospital No. 1, Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0007-8336-7260
Natalia Sztenc Pomeranian Medical University, Szczecin, Poland https://orcid.org/0009-0006-4307-7958

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5501

Keywords:

ADHD, Guanfacine, Alpha-2 Agonists, Prefrontal Cortex, Non-Stimulant Treatment

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition associated with persistent impairments in attention and executive functioning. Although psychostimulants remain the most effective pharmacological treatment, not all patients tolerate them well, and a considerable proportion shows only partial response. For this reason, interest in non-stimulant medications, including guanfacine, has grown in recent years.

Guanfacine, a selective α2A-adrenergic receptor agonist, primarily acts on prefrontal cortical networks involved in cognitive control. This review summarizes current evidence on its mechanism of action, clinical efficacy, and safety profile. Overall, available data indicate that guanfacine provides clinically meaningful benefits—particularly in pediatric populations and as adjunctive therapy—although its effect size is generally smaller than that of psychostimulants. Nevertheless, due to its favorable tolerability and distinct pharmacological profile, it represents a useful option within individualized treatment strategies.

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