Abstract
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.
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