ADHD Medications - Part IV - Alpha2 Drugs (e.g.Guanfacine)

The past 10-15 years have witnessed a number of major developments in the medications and delivery systems available for the management of ADHD. Dr. Barkley here discusses the types of medications now available to ADHD management and the various delivery systems developed to extend the effectiveness of the medications across the day. For each medication, he will present the major beneficial effects and side effects. He will also discuss various issues clinicians should consider in selecting particular medications to use with a patient with ADHD, such as those issues related to the social context, the patient’s characteristics, and any comorbid conditions that may exist.
Part IV discusses the alpha2 medications, specifically guanfacine XR

[@JC-Alan]

Guanfacine has been incredibly helpful for my working memory. If anyone has specific issues with working memory, I recommend asking your Psych about trying this. Mine gave it to me to also help with sleep and it has been great in that regard. In combo with my primary medication (Adderal XR) I find it to be very helpful.

[@webbedshadow2601]

Awesome I'm excited to hopefully try it and see how much my memory improves! 🙂

[@TroyHill442]

Good video. Guanfacine is interesting. It has dramatically enhanced my memory. Sometimes i feel almost TOO relaxed on it, though. However, I'm also on testosterone replacement theapy and as a bonus the guanfacine really helps keep my blood pressure like 110/70, even with Adderall.

[@bananas389]

How does guanfacine interact with adderall for you? I'm hoping it balances everything adderall does

[@4144758]

Bump

[@xxxafterglow]

I am on Strattera and just added Guanfacine - WOWWWWWW it’s awesome! Better emotional regulation and decreased anxiety = better functioning, more task initiation.

[@webbedshadow2601]

That sounds great! I'm on Straterra right now and it's helping my ADHD but my high heart rate is making me worried cause I already have anxiety that's the reason I can't handle stimulants, I'm thinking adding Guanfacine would be perfect for me and I should give it a try. How's it going for you?

[@therealist2000]

This is what I’m hoping for, I respond well to both individually.

[@4144758]

How is it now 7 months on?

[@andiblac]

Thank you so much for sharing your years of knowledge and expertise Dr. Barkley! It's truly helped me and my daughter so much when speaking with our doctor and counsellor. I had a curious question. For patients who experience elevated heart rate from stimulants, is there any evidence of taking Guanfacine in tandem to a stimulant mitigating heart rate elevation?

[@russellbarkleyphd2023]

Not to my knowledge, unless of course by taking guanfacine you wind up using a lower dose of the stimulant.

[@DadThrowawayADHD]

Greetings Dr. Barkley, and thank you for your great work. A brief question for you... I've seen you mention in your other videos that starting ADHD children on stimulants early can help with their neural connections later in life. Does this particular benefit also apply to Guanfacine, a non-stimulant?

[@Madkalibyr]

I recently began taking Guafacine alongside my Adderall IR (I prefer XR but have no been able to get it filled in six+months)

[@olgavysotska]

Thank you so much Dr. Barkley! Can you combine Strattera and Guanfacine, or is it only stimulants that can be taken alongside Guanfacine? Thank you so much in advance🙏

[@russellbarkleyphd2023]

If clinicians are combining them, which is not very common, then it would be a stimulant with either a NERI drug like Atomoxetine or an alphas 2 like guanfacine. But combining those latter two is not something I have seen any research on and I imagine would be quite rare.

[@karikaru]

I had the same question as someone on atomoxetine in a country where stimulant medications are illegal. I find my atomoxetine is of limited benefit and doesn't help with my memory issues. I was curious if adding guanfacine could in a low dose could be suitable in such a situation. Hope to see some more research on this soon.

[@blueyepasta]

Hi Dr Barkley, this drug changed my life in a much more effective way than stimulants. I also have Autism and now i can finally look people in th eyeys while having a conversation. cures my anxiety completely.

[@4144758]

How long have you been on it Is it still as effective as before?

[@admiral7599]

Back when I couldn't get Stims(Still can't because of the seizure myth ofc) I was prescribed this. I really didn't feel anything much other than improving my OCD/Anxiety and ADHD Hyperactivity(Which I for some reason still have at age 25, although it has weakened over time). But it made me sleepy and kinda dull and I did have the dry mouth side effect. I stopped cause I didn't think it did anything much other than help OCD rituals calm down, but hopefully I might try this again if I get stimulants.

[@ronnie-lynn]

I’m 37 and I this also helps my hyperactivity which has only gotten worse for me with age (as a woman) for some reason. Also it helps my OCD/Anxiety as well but it costs me 155$ for 30 days as my benefits do not cover the drug. But I do notice that I feel really dull these days. And appreciated that you also shared that in your comment.

[@__-qg7yd]

​@ronnie-lynn 😮 $155..? I've searched "ADHD" on the Google, and found out RX gave me $30 per month, but the first month you need to pay online co pay, nurses talk with you. Check that out if you need it

[@lisatrujillo1083]

Thank you so much for your work Dr Barkley! Is Guafacine XR more effective at treating mood regulation and possibly RSD more so than Clonidine XR in adults? sleepiness aside

[@russellbarkleyphd2023]

It may have fewer side effects for some people than clonidine but its not necessarily more effective.

[@AngelChristinaaa]

But what about children who have the inattentive type and are not hyper at all. My daughter has been on Guanfacine and her test scores went up 20 points. (On state tests.) What is ur treatment plan for kids who are not hyperactive and who don’t have behavioral issues? I never see any videos anywhere about this kind of child, therefore I don’t know what the treatment plan should be long term… I’d say this medication works good but not exceptionally well.. Would a lose dose stimulant help even more?

[@russellbarkleyphd2023]

Please see my lecture on cognitive disengagement syndrome, which many people with inattentive ADHD and no hyperactivity or impulsivity are most likely to have instead of ADHD. Be well m

[@AngelChristinaaa]

@@russellbarkleyphd2023 Oh wow. Never heard of this syndrome before. I will definitely look up your lecture on that. Thank you so much.

[@andreashrewsbury884]

I am months from being 50 and have been taking Guanfacine since about age 8 for tics. A diagnosis of ADHD came when i was 10-11, and was prescribwd Desoxyn at that time. Treatment over the years has become shoddy. Today, i can't find any psychiatrist in my surrounding area that will treat (not only adult ADHD appropriately and I am so frustrated. I clearly present symptoms, try to make adjustments in my self-actions (i know thats not a word), and feel for so long now- i NEED treatment. What can I do? Where can I i go? Who can help?

[@johnmoore1495]

Why should guanfacine not be used with aripiprazole?

[@AleeahTao]

Yes I hope he can answer this soon

[@4144758]

Research

[@ubded9597]

It’s increase or decrease Noradrenaline?

[@Herfinnur]

Is this the best medication for CDS? Is there any data on combining Guanfacine with Medikinet? Although now that I think of it, my only ADHD symptoms seem to be time blindness and working memory

[@russellbarkleyphd2023]

We have so little research on meds for CDS that one simply cannot say with confidence what will help treat it.

[@Herfinnur]

@@russellbarkleyphd2023 thank you for the reply! Well, I'll try to persuade my psychiatrist to reevaluate me so we can start looking into different or additional medication. The Medikinet does work very well for getting things done though. Unfortunately it's the kind that hasn't been approved for adults, so my insurance won't pay for it. Do you know why only Medikinet Retard is approved for adults within the EU? It seems to be a total mystery to practitioners, and the Retard variant gives me debilitating anxiety

[@Yahman1969]

Do you think ADHD medication could help with PTSD

[@user-xv5gq7ne3e]

I take venlafaxine and Guanfacine together. EMDR may be more beneficial than medication.

[@Yahman1969]

Bupropion?