Guanfacine and irritability

[Pema20]

My 17 year old started Guanfacine 6 days ago. She seems quite a bit more irritated than usual. Does anyone have experience with this and did it go away once adjusted to the medication or is this an indicator of a bad fit?

[Imakecutebabies]

Guanfacine made my son LESS irritable.

[Trying1978]

So my son is only 7, but we had to stop guanfacine after a week. It was supposed to calm him down a lot, but he had a totally paradoxical reaction: full-on panic attacks, terrible anxiety about bugs. It was awful! Hang in there!

[arrh121]

Are you using immediate or extended release? In our case, immediate was less effective and had more side effects and we had more success with extended release (and also using atomoxetine). Our son is on guanfacine ER and atomoxetine and they work well for his irritability and impulsiveness. That's all he takes. He is much younger though

While our doctor said it could take a while to see if it was working, it was pretty clear within a few days for us what was and what wasn't. I'd definitely check in with your doctor after a week at most.

[Pema20 in reply to arrh121]

extended release

[Bookworm365]

Hello! Our child is much younger but was on guanfacine ER alongside vyvanse for several weeks before we stopped the guanfacine. He was incredibly irritable, very rigid/inflexible in his thinking, and was very sleepy. He also seemed to have a lot of nightmares. For us, it was a bad fit.

[Pema20]

thanks everyone, yesterday was a better day. She seemed much calmer. We are going to stick it out a little longer and see if it was the Guanfacine, fatigue from taking it in the AM (we switched to PM a few days ago) or something else. I will come back to let you know where we land in case there are lessons for anyone else.

[simplething]

My 11 year was started on 1 mg Guanfacine ER last August at bedtime. We noticed great results in the first week with his impulsivity and figiting but then the irritability started. When I asked him about why he felt so irritable he said the medicine made him feel so tired and like "his head was foggy". We road it out and after 4 weeks he mentioned that he felt more "normal" again and less tired. This was all going well until about 2 months ago. Now he was not able to sleep more than 4 or 5 hours a night. Sleep is very poor for ADHD individuals as their minds are always active. His psychologist suggested changing the med to a morning dose which we slowly dialed back by a few hours over a long weekend. Again it took almost a month to get around the sleepiness and irriablity but now better and sleep at night has improved again.

[Pema20 in reply to simplething]

this is super helpful, thank you!! We will stick it out a while before making a decision.

[anirush]

The first time my grandson was put on Guanfacine he got super aggressive and we stopped it. Years later a doctor added it to his other medication and it made a world of difference. At 17 he is still on it.

[Pema20]

We stuck it out and by about 10 days she had no real side effects at all, but no benefits either. So, basically, it is worth sticking it out to three weeks to see if side effects persist or not. The Psych just upped her to 2mg. We will see how that goes. I think she has been a bit calmer, but it’s also summer, so the things that set her off, school, are not as much of an issue, though she will start working on college applications next week. We will see how that goes.