Guanfacine is a prescription medication used to address specific medical conditions. While beneficial for its intended uses, it carries a potential for misuse. Understanding the appropriate use and potential risks associated with this medication is important for patient safety.
Guanfacine’s Intended Use and Misuse Pathways
Guanfacine is legitimately prescribed to treat high blood pressure (hypertension) in adults and, for Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents (extended-release forms like Intuniv). It functions as a centrally acting alpha-2A adrenergic receptor agonist, influencing nerve impulses to relax blood vessels, lower blood pressure, or improve attention and reduce restlessness.
Although guanfacine is not classified as a controlled substance and does not typically produce a euphoric “high,” misuse is still possible. Misuse includes taking higher doses than prescribed, consuming it without a valid prescription, or combining it with other substances. These actions can alter its intended effects and lead to unforeseen health consequences, despite its non-stimulant nature.
Recognizing Misuse and Its Health Risks
Recognizing guanfacine misuse can be challenging, as overt signs commonly associated with substance abuse are not always present. Behavioral indicators include seeking additional prescriptions, fabricating symptoms, or running out of supply early. Physical signs include unusual dullness, excessive sleepiness, or fainting (syncope).
Misusing guanfacine carries a range of health risks, some of which are severe. Overdosing can lead to extreme drowsiness, pinpoint pupils, blurred vision, dizziness, and decreased energy. More concerning effects include dangerously low blood pressure (hypotension), slow heart rate (bradycardia), seizures, or unresponsiveness.
Rebound hypertension is a danger if the medication is stopped abruptly. This involves a rapid and potentially dangerous increase in blood pressure and heart rate. Combining guanfacine with alcohol or other central nervous system depressants, like antihistamines, can significantly increase central nervous system suppression, leading to dangerous sedation and slow heart rate. Long-term misuse may also contribute to constipation and adverse liver effects.
Seeking Help for Guanfacine Misuse
If guanfacine misuse is suspected, seeking professional medical help is a prudent first step. A healthcare provider can assess the situation and develop a safe plan to address the misuse. Abruptly stopping guanfacine is not recommended due to the risk of withdrawal symptoms, including rapid blood pressure increase, tremors, agitation, nervousness, headaches, and anxiety.
Medical supervision is necessary for tapering off the medication gradually, typically reducing the dose by no more than 1 milligram every 3 to 7 days. This supervised reduction helps the body adjust and minimizes withdrawal effects like lightheadedness, nausea, or insomnia. Treatment also includes counseling, therapy, and support groups. These can address underlying factors contributing to misuse and provide coping strategies. Professional guidance ensures safe and effective intervention, especially with co-occurring substance misuse or mental health conditions.