What is Guanfacine?

Guanfacine belongs to a class of non-stimulant prescription drug medication known as centrally acting alpha2A-adrenergic receptor agonists, traditionally used to treat high blood pressure.  It comes in tablet and extended release tablet form and is usually taken at bedtime.  Extended release tablets can be used to treat ADHD, as an alternative to stimulants in kids and adolescents. It works by controlling nerve impulses along pathways in the brain, allowing the blood vessels to swell so blood can pass through easier, thus decreasing blood pressure.  Other brands of guanfacine include Intuniv and Tenex.  Guanfacine should not be combined with alcohol or other depressants (such as antihistamines such as Benadryl)  as it will cause increased Central Nervous System suppression.  

Guanfacine should not be used with the following medications due to potential for harmful drug interactions:

  • Abametapir
  • Conivaptan
  • Fedratinib
  • Fexinidazole
  • Fosnetupitant
  • Iobenguane I 131
  • Netupitant

Before beginning Guanfacine, tell your healthcare provider if you have any of the following medical conditions:

  • Liver disease
  • Kidney disease
  • History of fainting
  • Have had a stroke
  • Kidney failure
  • Low blood pressure
  • Heart rhythm problems, such as AFIB
  • Heart disease
  • History of a heart block or heart attack
  • Depression or other mental health conditions
  • Breastfeeding mothers
  • Children under the age of 12

Your doctor may decide to start you on a different medication to avoid further complications to your health.

Guanfacine Effects

The primary effect of guanfacine is lowered blood pressure and control of ADHD symptoms, however, like all medications, there is a risk of side effects which include:

  • Abnormally tired or weak
  • Dry mouth
  • Decreased sexual arousal
  • Decreased appetite
  • Stomach pain
  • Constipation
  • Blurred vision
  • Sweating
  • Dizziness when standing 
  • Chest pain or tightness in the chest
  • Increased urination
  • Irregular heartbeats
  • Agitation or depression
  • Headache
  • Fever
  • Numbness in arms, legs, or face
  • Skin abnormalities, such as cracked skin, redness, swelling, or scaly skin
  • Auditory or visual hallucinations
  • Seizures

Signs of Guanfacine Abuse and Addiction

Guanfacine is not a commonly abused medication and is not an FDA controlled substance, however, there are instances when it is abused.  It doesn’t provide a “high” that is typically desired in drugs that are abused.  It can be abused for its appetite suppressant effects which would result in rapid or significant weight loss.  Other signs of abuse or addiction would include taking the medication more than prescribed or running out of the medication quicker than it is prescribed to.

Guanfacine Withdrawal Symptoms

Guanfacine should be taken as prescribed and should not be discontinued without first speaking to your doctor.  Depending on the dose, your doctor may taper your dose down until you can discontinue it to avoid withdrawal symptoms.  While rare, withdrawal symptoms can include:

  • Nervousness
  • Headache
  • Tremors
  • Agitation

It is possible to overdose on guanfacine if taken improperly.  Signs of an overdose are:

  • Pinpoint pupils
  • Extreme drowsiness
  • Blurred vision
  • Dizziness
  • Decreased or no energy
  • Fainting
  • Seizures
  • Difficulty breathing
  • Inability to wake 
  • Bradycardia (slow heart rate)
  • Hypotension (low blood pressure)

If any of these symptoms occur, call 911 and seek immediate medical attention.

Long Term Side Effects of Guanfacine Abuse

Long term side effects can include:

  • Change in taste
  • Cough
  • Muscle cramps, muscle pain, stiffness
  • Pain in joints or joint swelling
  • Inability to obtain or keep an erection
  • Sexual disfunction or lose of interest in sexual activities
  • Hair loss
  • Trouble sleeping
  • Heartburn
  • Indigestion
  • Dry, itchy eyes

Guanfacine Addiction Treatment

Guanfacine addiction treatment is much like treating any other addiction.  Treatment utilizes a combination of behavioral and emotional therapies.  Goals of treatment focus on identifying the root causes of addiction so these can be addressed in therapy.  Oftentimes, those who suffer from addiction have experienced some form of trauma, have an underlying mental health condition, or have a family history of addiction.  Addiction treatment helps you learn ways to cope with those things, find alternative coping skills for stressful situations, adjust and treat untreated mental health conditions, provide accountability, and help you live a happier, healthier life.  

Addiction treatment can be in an inpatient setting, where you would live at the facility where you receive treatment so you can receive around the clock care and more intensive addiction treatment.  This is ideal for someone with an aggressive addiction or someone who does not have a stable home to return to.  Outpatient programs would likely be best for a guanfacine addiction as it provides more flexibility in treatment and is usually a less expensive option than inpatient.

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