Prescription drug

Guanfacine

A non-stimulant for ADHD (Intuniv): an alpha-2A adrenergic receptor agonist; improves prefrontal regulation. Used alone or added to a stimulant.

In practice

By prescription, in extended-release form; adjusted gradually and must not be stopped abruptly. Dose individualized by the physician.

Precautions

Prescription drug with follow-up. Effects: drowsiness, sedation, hypotension, and bradycardia; do not stop abruptly because of the risk of rebound hypertension.

Effect by goal · level of evidence

ADHD

improves Very high network meta-analysis (AAA)

It is effective on ADHD symptoms as a non-stimulant and is especially useful in combination with stimulants or when there are sleep problems, tics, or marked hyperactivity (comparative evidence, Cortese 2018).

View the source (network meta-analysis) →

In depth

Guanfacine

⏱ 3 min read

A non-stimulant for ADHD (Intuniv): an alpha-2A adrenergic receptor agonist; improves prefrontal regulation. Used alone or added to a stimulant.

How it works

It stimulates postsynaptic alpha-2A receptors in the prefrontal cortex, strengthening the connections involved in attention and impulse control.

Efficacy and use

It is used alone or as an add-on to a stimulant. Its sedating effect can help when there is insomnia or marked hyperactivity. Adjustment is gradual.

Safety

Monitor blood pressure and heart rate; avoid abrupt withdrawal. Indication and adjustment are always medical.

References

Cortese, S. et al. (2018). Comparative efficacy and tolerability of medications for ADHD in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 5(9), 727-738. PMID:30097390

Information, not medical advice. Prescription drug: its indication, dose, and monitoring are up to a health professional.