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Attention deficit hyperactivity disorder or ADHD affects a significant percentage of the population, as it has been diagnosed in more than 6 million children. ADHD is typically diagnosed in childhood, and can impact an individual's ability to focus, control impulses, and manage hyperactive behaviors.
The first line of treatment for those diagnosed with ADHD are typically stimulant medications, as they have the most effective results in managing symptoms of ADHD. However, stimulant medications are not the only options available. For instance, doctors may forgo stimulant medications and prescribe nonstimulants, antidepressants, and alpha agonists as these have been effective options in treating ADHD.
This article will explore Guanfacine, or a common alpha agonist medication and how it compares to stimulant medications, such as Adderall. Keep reading to learn more about Guanfacine's use for ADHD, Guanfacine's effectiveness, side effects, and risks.
If you want to learn more about other Adderall alternatives to keep your child focused, read this article from Joon.
What Is Guanfacine?
Guanfacine (brand name: Intuniv) is a non-stimulant ADHD medication and it is commonly used in combination with stimulant medications.
While stimulant medications tend to be the first line of treatment for ADHD, it may not help with behaviors such as impulsivity, hyperactivity, and behavioral or emotional control. Guanfacine belongs to a class of medications known as alpha 2a specific adrenergic receptor antagonists or, alpha agonists.
Guanfacine for ADHD can be helpful for individuals who cannot take stimulants due to their undesirable side effects or who do not experience any benefits from them.
Other Uses
Besides managing symptoms of ADHD, Guanfacine has been studied for use in treating high blood pressure, anxiety, depression, and substance use disorder.
Treat High Blood Pressure
Guanfacine is used to treat high blood pressure or hypertension in adults. It works by relaxing blood vessels and slowing down the heart rate, which helps reduce blood pressure.
It is also important to note that Guanfacine should only be used under the supervision of a doctor or medical provider and that the appropriate use of Guanfacine will vary depending on the individual and their specific needs.
Does Guanfacine Work Like Adderall?
Guanfacine and Adderall are both prescription drugs used to treat ADHD symptoms. However, they work very differently and belong to different drug classes.
Guanfacine, as mentioned previously, is a medication that works by relaxing blood vessels and slowing heart rate, which also helps to reduce blood pressure.
Adderall is a combination of two stimulant ADHD medications (combined stimulant) known as amphetamine and dextroamphetamine. Adderall treats attention deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall works by increasing the levels of certain neurotransmitters in the central nervous system, which help with concentration, focus, and alertness.
The main difference between Adderall and Guanfacine is that Guanfacine is a centrally acting alpha agonist that has a calming effect on the brain. Adderall on the other hand, is a stimulant medication that increases the activity of certain neurotransmitters in the brain.
It is important to note that, as with any medication, the effectiveness will vary from person to person and some individuals may not respond to one medication, while others will. Therefore, consult with your child's doctor to determine the best medication option for treating ADHD.
How Is Guanfacine Used for Attention Deficit Hyperactivity Disorder?
Guanfacine or Intuniv is an extended release (XR) medication that has been FDA approved only for use in children ages 6-17. It has not been studied or approved for the use in children under ages 6 or adults over the age of 17.
Considering Guanfacine is an alpha agonist, it activates receptors on nerves that use adrenaline as their receptor. In other words, the activation of these receptors tricks the adrenaline nerve into being less active. This is helpful because adrenaline prepares the body for fight or flight, so tricking it into becoming less active will reduce an individual's blood pressure and also decrease an individual's hyperactivity, impulsivity, and emotional lability.
Basically, Guanfacine has a calming effect on the brain, making it a useful option for treating symptoms of ADHD.
Dosage of Guanfacine
Guanfacine is available in the following formulations:
- Immediate Release Tablet (Guanfacine IR). This should be taken up to twice a day and it is available in 1mg or 2mg doses.
- Extended Release Tablets (Guanfacine ER). This should be taken once daily in the morning or evening at approximately the same time each day. Guanfacine extended release or Intuniv is available in 1mg, 2mg, and 4 mg dosages.
The specific dose will vary based on personal preferences and by the condition that is being treated.
Side Effects of Guanfacine
Like any medication, there are potential side effects. However, most individuals that are prescribed Guanfacine do not experience side effects. Be sure to read the complete list of side effects that can be found on the back of the medication label. The most commonly reported adverse effects reported from the Mayo Clinic are as follows:
- Tiredness or weakness
- Confusion
- Low blood pressure (this is usually seen as dizziness when standing up too quickly from a lying position)
- Blurred vision
- Sweating
- Chest pain or discomfort in chest
- Increased need to urinate
Other side effects that are less common:
- Vomiting
- Fast, slow, or pounding heartbeat
- Difficulty breathing
- Nausea
- Stomach pain
Side Effects of Adderall
Although stimulant medications like Adderall are the first like in treatment of ADHD, it can be associated with unwanted side effects. These side effects include:
- Increased nervousness and agitation
- Insomnia or trouble sleeping
- Loss of appetite and weight loss
- Headaches
- Stomach problems, such as nausea and vomiting
- Increased heart rate and blood pressure
- Dizziness
- Blurred vision
- Chest pain
- Sweating
- Mood swings and irritability
It is important to note that these side effects will vary from person to person and not everyone will experience the same side effects. Here's our full list of other options than Adderall.
Risks of Guanfacine
There are risks associated with taking Guanfacine and these can include drowsiness, especially when the dose is first increased. In addition, Guanfacine can cause low blood pressure, cause dizziness, dry mouth, constipation, sexual side effects, depression, and heart problems.
Discussing these risks with your child's doctor is important to determine the correct treatment plan for your child. The doctor can also monitor symptoms and side effects and adjust the Guanfacine dosage as needed to manage adverse side effects.
Risks of Adderall
Consider learning about the risks of taking stimulant ADHD medications, as they can have risk factors associated with taking the medication. The risks associated with its use in children include:
- Growth Suppression: Adderall can cause a reduction in growth in children, which may affect height and weight.
- Cardiovascular Effects: Adderall has been linked with increasing heart rate and blood pressure. This can be concerning for children, especially individuals with pre-existing heart conditions.
- Mental Health Effects: Adderall can cause or worsen mental health symptoms such as anxiety, agitation, and irritability.
- Sleep Problems. Adderall can cause insomnia, which interferes with an individual's ability to get an adequate amount and quality of sleep.
Be sure to discuss the benefits and risks of Adderall with your child's doctor to determine if stimulant medications are the correct treatment option for your child.
What to Ask your Child's Doctor
If you are considering taking your child to the doctor to be prescribed an ADHD medication, there are a few important things you should discuss with the doctor to determine the right treatment plan for your child and their specific needs.
Here are some questions you should consider asking:
- What medications are used to treat ADHD? What other medications are available, besides stimulants?
- What is the typical dose and how long does the medication take to begin working?
- Are there any side effects I should be made aware of?
- Will this medication have drug interactions with other medications? What about herbal supplements?
- Is there a generic version of this medication available?
- Are there any lifestyle changes my child should make to help the medication work better?
- Will this medication cause weight loss or weight gain?
- Are there any long-term risks associated with taking this medication?
- What are the most effective ADHD treatment options?
As you work with your child's doctor to develop an effective treatment plan for your child's ADHD, it is important to be open and honest about your child's symptoms, medical conditions, and any concerns you may have. This will allow your child's doctor to provide appropriate medical advice and the best options to treat ADHD symptoms, based on your child's specific needs.
Takeaway
There are a variety of treatment options and medications available to manage symptoms of ADHD, each coming with their own list of benefits, side effects, and risks. The most effective treatment plan will typically include a combination of ADHD medications, behavioral therapy, and lifestyle changes, such as managing diet and exercise.
When choosing an ADHD medication for your child, whether it be Guanfacine or Adderall, it is really important to have consistent collaboration with your child’s doctor, psychologist, your child’s school, and family members to monitor your child’s progress and symptoms and to make any necessary changes to the treatment plan.
About
Dr. Carrie Jackson, PhD
