Guanfacine is a non-stimulant medication used to manage Attention-Deficit/Hyperactivity Disorder (ADHD). It offers an alternative for individuals who may not respond well to stimulant medications or experience undesirable side effects. This medication works as part of a comprehensive treatment plan that often includes psychological, educational, and social support.
Understanding Guanfacine’s Action in ADHD
Guanfacine functions as a selective alpha-2A adrenergic receptor agonist, targeting and activating specific receptors in the brain’s prefrontal cortex. This region is responsible for executive functions like attention, working memory, and impulse control. By stimulating these receptors, guanfacine enhances the regulation of norepinephrine, a neurotransmitter crucial for these cognitive processes.
This activation helps strengthen signaling in the prefrontal cortex, improving the “signal-to-noise ratio” in brain networks. This makes it easier to process relevant information and filter out distractions. Guanfacine achieves this by enhancing the effectiveness of signals in prefrontal cortex neurons. This mechanism differs from many stimulant medications.
Impact on ADHD Symptoms
Guanfacine alleviates core ADHD symptoms, including inattention, hyperactivity, and impulsivity. Studies show that children taking guanfacine experience a decrease in these symptoms. This improvement reflects better focus, reduced restlessness, and more controlled actions.
Guanfacine may also benefit emotional dysregulation, which often co-occurs with ADHD. The medication contributes to better cognitive and behavioral regulation. While symptom improvement is clear, research continues to explore how these improvements translate into daily functioning across various domains like school, family, and social interactions.
Administering Guanfacine
Guanfacine is prescribed as an extended-release tablet, taken once daily. The dosage typically begins low, often at 1 milligram per day, and is gradually increased in increments of no more than 1 milligram per week. This gradual increase, or titration, allows the body to adjust to the medication and helps minimize potential side effects.
The maximum daily dose can vary, ranging from 4 to 7 milligrams per day depending on the individual’s weight and age. It is important to administer guanfacine consistently every day, not just on school days, to maintain its effectiveness and avoid potential issues. Tablets should be swallowed whole and not chewed or crushed, as this can affect the extended-release properties.
Potential Side Effects and Important Considerations
Common side effects associated with guanfacine include drowsiness, fatigue, headache, dizziness, and dry mouth. These effects are often more noticeable when starting the medication and may lessen over time. Patients may also experience abdominal or stomach pain, constipation, decreased appetite, and lethargy.
Due to its action on the cardiovascular system, guanfacine can cause a reduction in blood pressure (hypotension) and a slower heart rate (bradycardia). Monitoring blood pressure and heart rate is often necessary, especially when initiating treatment or adjusting the dose. There is a risk of increased blood pressure if the medication is stopped suddenly, so discontinuation should involve a gradual tapering of the dose. Concomitant use with other central nervous system depressants, including alcohol, may worsen sedative effects. It is important to discuss all existing health conditions and other medications with a healthcare provider to avoid potential interactions.