Epidemiology and toxicity of pediatric guanfacine exposures

OBJECTIVE: To examine the epidemiology and toxicity of guanfacine exposures in children and adolescents reported to poison control centers. METHODS: Guanfacine exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System from 1993 to 1999 in children and adolescents <19 years of age were analyzed. RESULTS: There were 870 cases that met the inclusion criteria: 478 (54.9%) were children <6 years old, 304 (34.9%) were 6-12 years old, and 88 (10.1%) were adolescents 13-18 years old. The number of cases increased eight-fold over the 7-year period, with the largest increase in children <13 years of age. Analysis showed 29.7% of exposures were managed on site (non-healthcare facility) and 68.3% were managed in a healthcare facility. There were no symptoms in 546 (62.8%) children. In 324 symptomatic children, the most common symptoms were drowsiness/lethargy (76.8%), bradycardia (30.0%), and hypotension (25.8%). The majority of cases were acute (77.5%), 182 (20.9%) were acute-on-chronic, and 14 (1.6%) were chronic. Children aged 6-12 years represented the majority of the acute-on-chronic and chronic exposures with (n = 118). Overall, there were 195 (22.4%) exposures coded as minor, 121 (13.9%) as moderate, and 8 (0.9%) as major effects. CONCLUSIONS: These data demonstrated a trend of increasing numbers of guanfacine exposures annually. Although the majority of children experienced minimal or no toxicity, serious toxicity can occur.