Replacing Guanfacine with Clonodine - do I titrate Guanfacine?

[missbonafide]

Hello

We will be starting my 6 yo on Clonodine and stopping Guanfacine. WhenI asked the doctor if we need to titrate Guanfacine first she said no that they could be replace with each other.

Just wanted to ask here if you did that for those of you that replaced Guanfacine w/ Clonodine.

My son has been on ER Guanfacine since March 2022 and it worked well but since this summer he has been waking up after 2-3 hours of being asleep and will not sleep in his room says he is scared or having nightmares. Looks like anxiety to me honestly....

So his current child psychiatrist wants him to get off guanfacine and try Clonodine at night...

Just looking to hear for those that switch how you did and any input...we are just hoping he can finally sleep through the night and have that full rest mode and see if it helps w daytime behavior which has been aggressive and combative and now raging....

Thanks so much!!

[JJMom16]

What is the dose of Guanfacine? If it's 1mg, you should be able to stop without tapering.

Note: We had the same issue with Guanfacine and sleep a year ago when we first tried it. Trying it again a year later, we no longer had insomnia.

Re: Clonidine, my 6.5-year-old son has taken Clonidine ER 1mg consistently for nearly two years and sees improvement in sleep. Sleep is a big factor in mood, but even with Clonidine, we're still seeing a lot of emotional dysregulation, unfortunately.

Good luck!

[missbonafide in reply to JJMom16]

guanfacine 1mg in AM and 1mg in PM. Changing to 0.1mg Clonodine in evening.

Thanks for feedback.

[anirush]

If the guanfacine had been working well why would the doctor not try adding something for anxiety or sleep rather than stopping a medication that is working?

[missbonafide in reply to anirush]

we want to see if the sleeplessness in being caused by guanfacine. A lot of parents I’ve read said intuniv caused this and many switched to clonidine and had better result.

It’s trial and error.

[WizKidMama]

We are just the opposite. My daughter started on Clonodine, but that gave her insomnia, so we switched to Guanfacine. We didn't have to taper, just made the switch. We had to adjust the time of day & number of doses she took, but finally got the right one and she sleeps through the night now.

[missbonafide in reply to WizKidMama]

ok thanks for update !!