Hi! I just started this medication a couple of days ago for my ADHD symptoms and I was having a difficult time finding out what Guanfacine does in the brain. I find the neuroscience of medication fascinating. I found several peer-reviewed articles but the language is difficult to understand. 😅. Thank you for taking the time to put it into Layman's terms. This was very informative! I really appreciate your thorough description of risks/side effects; I was really worried about the blood pressure part of it. The understanding I received from this video makes me excited for the relief I hope to feel as I continue to take the medication. Best to you! Thank you for what you do!
🎯 Key Takeaways for quick navigation: 00:00 💊 *Introduction to Guanfacine and ADHD* - An introduction to guanfacine, a non-stimulant medication used for treating ADHD. - Guanfacine is an alpha agonist, specifically acting on the alpha 2A receptor system. - It was originally approved for lowering blood pressure in 1986. - There's a concentration of alpha adrenergic receptors in the prefrontal cortex, affecting ADHD symptoms. 01:39 🧠 *Mechanism of Action and Effects on ADHD* - Explaining how guanfacine works on ADHD symptoms and its impact on the prefrontal cortex. - Guanfacine stimulates the prefrontal cortex, leading to greater coordination of neurons firing. - It helps in improving a broad range of ADHD symptoms like hyperactivity, impulsivity, and emotional overreactivity. - Studies have shown its benefits in enhancing productivity, planning, and organization in ADHD patients. 03:28 📊 *FDA Approval and Benefits* - Discussion on the FDA approval of guanfacine and its benefits for ADHD treatment. - The FDA approved a long-acting form of guanfacine under the brand name Intuniv for children aged 6 to 17. - Studies indicated measurable improvements in various ADHD symptoms like inattentiveness, sleep disturbances, and emotional overreactivity. - The drug offers sustained benefits, with some studies showing improvements lasting longer than a year. 06:30 🔄 *Combination with Stimulant Medications* - The use of guanfacine in combination with stimulant medications to enhance tolerability and efficacy. - Intuniv can be prescribed in conjunction with a stimulant to improve its tolerability. - Some individuals who couldn't tolerate stimulants before can do so after being stabilized on guanfacine. - It helps in managing emotional volatility, sleep disturbances, and other ADHD-related symptoms when used with stimulants. 08:06 ⚠️ *Side Effects and Considerations* - Discussion on the potential side effects and considerations when using guanfacine for ADHD treatment. - Common side effects include sleepiness, sedation, nausea, and headaches. - Less common side effects like irritability, depression, and anxiety may occur. - The drug may lower tolerance for alcohol and could result in orthostatic hypotension in some individuals. 12:56 💲 *Cost and Comparison with Other Medications* - Information on the cost of guanfacine, both generic and brand name, and its comparison with other ADHD medications. - The generic version of guanfacine is more affordable than the brand name Intuniv. - Unlike some other ADHD medications, guanfacine has not been associated with an increased risk of suicidality. - The extended-release formulation may help in reducing side effects by maintaining consistent drug levels. Made with HARPA AI
Thank you so much. I completely tracked with you. I’m sorry for those who responded negatively. This is actually an answer to prayer for our family. Maybe people out there should be less self aware and speak in human kindness. There are families barely holding on because someone in their family suffers from ADHD.
Thank you for your kind words. I do believe that one of the most overlooked aspects of ADHD is how much chaos and distress it can inflict on loved ones.
It's actually quite amazing how there isn't a lot of information online about Intuniv/guanfacine. I have been on Adderall for many years but I recently added guanfacine due to anxiety and emotional issues etc. The combination has been life changing. Really amazing
Would you mind saying more? To be honest I’d love to talk with You directly as i can’t find any testimonials online. Would you be up to chat over some kind of messenger? I’ve been struggling with my ADHD actively for maybe 10 years and it’s been pretty brutal. Considering guanfacine because I think rejection and failure sensitivity drive a lot of my procrastination and focalin doesn’t address that at all.
My doctor had never even recommended it and when I brought it up after finding out about them on my own she said they aren't prescribed for adults. I still got her to write me a prescription, but it's weird that I had to find out about alpha 2 agonists with my own research considering how many different meds I've been on.
@@freetinkerer3878have you since tried it? How is it going? I’m in a similar position as you and was prescribed Guanfacine 3 weeks ago but still have yet to take it. Been on vyvanse for years. This would be in addition.
I definitely like guanfacine. It has positively affected my anxiety. Not much for focus and attention yet. I just upped my dose so we shall see. I like your videos! Very calm and informative
I would like to learn more how this med helps with speech impairmentfor children with ADD. My son had what I thought was a speech impairment. He started taking Guanfacine 3 mg HCL and now he is getting better after two weeks. His speech thought patterns have improved. I can't tell if the ADHD caused him to have Mixed up thoughts so they came out that way but I can finally talk to my son. I feel heard and he feels heard. People don't understand how this disorder makes families feel but I'm literally having meaningful conversations with my son...finally! Stimulants never helped...they turned him into a quiet zombie
Hey! Dr. Kruse is working on re-uploading his older live-streamed videos into edited videos with fixed audio. He has already started uploading some of them in the video section if you'd prefer to check those out. If you're still interested in the subject of Guanfacine he answers a couple questions about it, in the following videos that came out recently: ''Ozempic (The Weight Loss Med) for ADHD?'' - At 25:39 ''ADHD and Hoarding'' - At 26:07 More videos will keep coming out each week, have a good day!
3rd day on guanfacine. I can hardly take this video I’m literally feeling aggravated. That’s my general mood, slightly annoyed with everything. I do not like it. I hate this my friends with adhd that have stimulants have completely turned their lives around. And I’m here still can’t get anything done and plus have an added annoyance of just feeling dissatisfied. The dr gave me Prozac to take at night though I had no trouble sleeping before but I did have some anxiety. A couple people I know on the stimulants actually said they have less anxiety on them. I also can’t find many adults with reviews of this medicine. It’s super frustrating and that’s what I’m trying to get rid of is frustration and overwhelm in my life. Ughhhhh please pray for me or send good vibes.
I am not a doctor, just a mom with ADHD and three kids with ADHD. One of the possible side effects of guanfacine is aggravation/aggression. I know this because one of my kids has aggravation/aggression/emotional dysregulation that comes with ADHD and I’m looking for something to help mitigate it. Guanfacine seems to help many, but not ALL people with those symptoms so you might be one of them.
Thank you for the reply, I am still on it and I feel as though it or the Prozac, started both at the same time so I don’t know which one is doing it, has made my symptoms worse :( I’m making an appointment with my dr because I can not live like this I am fighting not to fall asleep at work, don’t want to get out of bed and my hair is falling out in clumps it seems all day. I am so sorry if this scares anyone but my goodness I didn’t expect any of this. Btw I am 29 and healthy no other conditions. I am scared to try anything else now :(
Been taking for 3.5 weeks until I stopped. I keep having to fight staying awake while at work or driving. Almost been in a couple car accidents with this. I have low energy already and always tired all day and this escalated that. I have ADD and afraid of stimulants. Wondering what I should do...I don't want this pill anymore and not sure what else to take. It has helped with my nervous tiks though.
Same i stopped taking mine over the weekend and am starting to get my energy back. I think my psychiatrist misunderstood the assignment. I am also afraid of ever taking stimulants daily again so me and a friend just split his adderall prescription cuz he also doesn’t need that much. You are an adult now so meds should be more about your own fulfillment than making life easier for others. Thats the real reason they made us take it everyday as kids. They just wanted us causing less problems
Nice video! Recently diagnosed adhd at 69. First med was stratera 25mg. I took it for about 6 weeks but told to stop by my pharmacist. I had increasing difficulty not being able to urinate. Difficult to start and puffiness around my bladder area. I had the other side effects you mentioned but they were tolerable. My man parts shrunk as well. Now on guanfacine 1 mg for about two months. Parts are back to normal and bladder normal again within a week. The side effects are just as you describe but all went away other than sleeping great again and noticing now better control over my emotional sensitivity and also better at being organized. I still write sticky notes every day but now find myself seeking to go read them and act on them. It is not wild but for me I’m very happy. I’m assuming I might go on a stimulant and try that to see if that helps other motivation type stuff. But if I don’t tolerate them I’m happy to stay on guanfacine. I’m impressed how a dinky 1 mg pill can do this for me. Thanks to all you people that make this happen. Tears of happiness
Hey, so you might want to try a stimulant aswell. Studies have shown that people with low dopamine have really low working memory, and by adding a stimulant they were able to increase their working memory (not needing sticky notes). Another thing to mention from these studies is that when people with already high dopamine and good working memory got a big dose of stimulants, their working memory actually decreased. If you are one of the low dopamine minded individuals man, without dopamine(stimulants) your working memory probably won’t improve atleast directly. All Guanfacine is helping with is norepinephrine which mostly helps in the initiation of tasks and focus. Stimulants have tolerance issues though, you will always need a higher dose with time. If you choose not to get stimulants, just try natural way such as cold showers, exercise.
@@plymix8389 thanks for sharing. In my practice, a very large percentage of individuals (close to 80%) don't become tolerant to stimulants, and continue to do well over years at the same dose. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-RsSnFVPRlFI.html
@@DrJohnKruse oh really? That’s really crazy. I actually took vyvanse 40mg and it literally just stopped working within 3 weeks. I only used it 3 times a week. Initially I did get immense relief, I went from lying in my bed all day to being able to to work on my personal projects and school for 10 hours straight. It was very amazing. My mind got accustomed to 40mg of it and I became even more impulsive because my mind was trying to reach for that dopamine in other things. The worst part about it is that I ran out of supply since it was not my prescription. I tried more but it still does not work. Anyways I had really terrible withdrawal and it ruined my Brain and it took months to be able to lower my baseline dopamine from abstaining from all the weird addiction and impulsiveness I started to do. I just got prescribed Guanfacine and I feel a lot better now. I’m on my 5th day. My hyper activity is literally gone since day 1 of taking it. For example I would go on 3-4 40+ minute car rides a day with my favorite music with top volume. Now I’m fine with a mid level of volume in my car and I don’t feel the urge to go on these drives. It’s incredible since it has dampened my hyperactivity to a normal baseline. I don’t have any of the mental benefits yet so I’ll be patient. But I’m already making less mistakes due to not rushing things and having less on my mind at any one moment. What I will add is that for some reason I got a much better relief on stimulants. When I took vyvanse and when it worked it was like a cold towel on my mind after a hot day. I just don’t get that with Guanfacine and it hasn’t helped with getting up and doing stuff. Should I go get prescribed for another stimulant or atleast somthing to increase norepinephrine? I actually had two separate effects when I took stimulants. One euphoric feeling and everything being fun to do. then the other was the mind claiming and the get up and go do things. I theorized that the mind calming and get up and go was norepinephrine so maybe I don’t need more dopamine and my mind will just be hungry and addicted to it. I just was thinking about getting something to boost strictly norepinephrine directly. Like straterra.
Great video as usual. Thank you I understand that it’s like most medications has an accumulative effect and it takes six weeks to start work but I also experienced initial effect when I first started it and I liked that initial effect a lot as it took me from being restless walking aimlessly around my apartment to immediately sitting on the couch for 5 hours and finishing my paperwork and that was just the first dose. I tend to be the jittery hyperactive kind and there is no way it’s placebo because I went from visibly shaky to calm and peaceful. Now after being on it for a while, I don’t like that it’s making me so sedately and I also miss deadlines because there is no adrenaline to care about consequences. You can say it works for anxiety, but works too good:) Now I’m thinking since I’ve experienced benefits from the first dose, would it be to still beneficial to take guanfacine as needed (when the jitter and the adrenaline anxiety attacks or before important work) instead of entirely quitting it?
I can't make specific medical recommendations, but if a patient reported this to me (and I have worked with a handful of individuals who reported immediate beneficial effects from guanfacine for their ADHD) I would think that it would be reasonable to experiment using it on an as needed basis. With guanfacine there is a theoretical potential for rebound hypertension after stopping a dose, but this appears to be much less frequently a problem with guanfacine than with the similarly acting clonidine. It might be a good idea to monitor blood pressure if using guanfacine intermittently.
Dry mouth and other mucous membranes is moderately common with guanfacine, but dry skin or rashes are less common. So it may just be how your body is responding to the medication, or it could also be a coincidence. If your doctor is aware that this is going on, then they may be able to work on a solution with you.
I've just had intuniv added to my elvanse stimulant med I often benefit with split doses, even with long release meds. Is there a benefit of taking say 1mg guanfacine in the morning, along side the elvanse, and then the final dose at bedtime? As opposed to taking it all at night. I have a very fast metabolism for medication, so it's a game of timings in order to stretch the effects long enough.
Most of our ADHD medications work through their direct biochemical effects, and response is proportionate to the blood/brain level at a given time. The experts say that this is true for the stimulants, but many of them claim that in contrast, atomoxetine, buproprion, duloxetine and other non-stimulants work more slowly. I disagree with them, based on both the neurochemistry, and my observations with scores and scores of patients. These other drugs all have immediate effects to make more norepinephrine or dopamine available, so we would expect ADHD benefits to be immediate as well. Guanfacine, however, really does seem to work slowly and indirectly for ADHD. So your blood level at a given moment is probably not particularly relevant to your response at that time. But you will need to achieve a high enough blood level to instigate whatever downstream changes in the brain are important to obtain benefit. The only benefit to splitting the dose would likely be if you can not tolerate the whole dose once a day.
Amazing information!! Explained so well I will say, as someone with ADHD it was a little hard to focus - but that’s a me problem not a you problem. LOL I appreciate this video! Ive been researching trying to find this information and couldn’t. Thank you thank you
My son is on 1 mg guanfacine and unsure if he wants to go up in dose as he wants to try a stimulant along side it. How much do people typically take of guanfacine with a stimulant? 2 weeks in and the guanfacine has helped his anxiety. Normally he has high systolic blood pressure with low heart rate so he’s nervous about going to 2 mg.
Without knowing your son's current and past medical history I can't give specific recommendations, but doses of guanfacine in the 1-4 mg range are common in conjunction with a stimulant. Guanfacine would be expected to be helpful in lowering systolic blood pressure without having detrimental effects on heart rate; stimulants have some likelihood of increasing both heart rate and blood pressure.
I wonder if the ones that approved this medicine for ADHD, have ever felt the bad symptoms of having low blood pressure. This medication MAY help with ADHD. That is written on the paper attached from the pharmacy. Of course, it will help with ADHD when your blood pressure gets down, your energy levels would knock you down and of course!!! It will help calm you down. I do not trust medication for high blood pressure be used for ADHD. IT'S MY EXPERIENCE AS A PERSON THAT SUFFERS FREQUENTLY WITH LOW BLOOD PRESSURE.
I appreciate you sharing your experience. The studies are quite consistent that most people who have benefit for their ADHD symptoms from guanfacine are not suffering with low blood pressure. That is not its mechanism of action.
i just got my perscription. 1 mg a day but i took 2 immediately, and feel pretty good. all my tics stoped and all impulsiveness stopped. Anyone else have adice regarding this?
im starting with guanfacine in a couple weeks because my blood bloodpressure (upper one) is always between 145-170 when i take my medication (lysdexamfetamine) and i only sleep 4 hours per night so i talked with my dr and i will start will guanfacine. Im only a little scared by all the side effects in the first couple weeks. But thanks for the information, im from Holland and the medicine is not very known here so it was really nice to watch this video. Thanks!
@John Kruse I have started with guanfacine and it feels way better to me than stimulants. Way more calm and my OCD is more dimmed, it feels really good. I talked with my dr and im gonna go +1mg per week so im starting with 2mg today. I saw lots of people say that they got sick/dizzy or so, but i notice nothing weird, except a dry mouth. I smoked a lot when using stimulants. I smoked around 15 cigarettes per day, and when i didn't took my stimulants, i smoked around 5 cigarettes per day. Now with guanfacine i don't even have the craving to smoke, i can smoke 3 cigarettes per day if i want but i've smoked lots of cigarettes per day when using stimulants so it has become a normal habit to smoke that much. I don't really know when the optimal response to guanfacine will be achieved. Can you maybe tell me that if you know that? (im sorry for my bad grammar, i did my best :) ) Thanks for your time!
@John Kruse i have one more question, i smoke weed sometimes (im 20 years old by the way) but does it interact with guanfacine? and if so, is it a bad mix? and does it make the guanfacine in my body last less longer or something?
@John Kruse by the way; i watched the video but i couldn't understand everything (my english is not the best) so im sorry if u already said it in the video 😅
@John Kruse Okay thank you very much for the information. Im using Guanfacine since the 3rd of January and it's going really well since the last 1 week. Im really feeling differences :) Ah okay, thank you for the information about cannabis. It's really helpfull, thank you very much for all the information. I really appreciate it! 😁
Dr, can it be given together with ARB blockers e.g. candesartan 16mg, as a 2nd BP medication (e.g. instead of a water pill such as indapamide 1.25mg)? Or at least, to combine it with indapamide but at a lower dosage than before?
Most blood pressure medications have been used in combination with others, because many people with hypertension don't have it controlled by one medication alone. It would be best to check with the doctor prescribing the first medication before adding another antihypertensive agent.
@@DrJohnKruse Most commonly, diuretics are prescribed as the second medication as they are a different class than ARB blockers. I am just wondering whether Guanfacine is a different class than ARB blockers since it also causes blood vessels to be more elastic. I am assuming it is less effective, I think maybe 6mm is the maximum effect in lowering BP. I'm just thinking whether it would be appropriate for older patients since it also improves focus and calms down
@@Burevestnik9M730 yes, the guanfacine is from a different class. There is so much individual variation in response to antihypertensives that it does not make sense to consider it as "less effective" - however your own body responds is what matters. It has been helpful for other older patients (for hypertension and for ADHD symptoms).
Positives: You have researched, care and addressing this. THANK YOU X Negatives: It's 8 minutes and done in a bit boring way - I mean I have ADHD - very hard to listen that long in monotone / 1 frame. Volume is too low - please turn up. Thanks anyway - will try watch in parts. Maybe meant for academics but if aimed towards ADHDers not easiest to take in. Love and peace lovely man x
very useful, thanks! Stimulants give me severe insomnia, I will ask my doctor about Guanfacine, maybe it can help with the stimulant-induced insomnia+anxiety
Our current framing is that ADHD is largely a problem with executive functions of the brain - how the brain controls and regulates itself. So having troubles monitoring and regulating one's attention might not be that different from being able to monitor and regulate or inhibit one's excessive movements.
Have you ever prescribed it with Buspirone 15mg/Melatonine 3mg combination? A research study showed that Buspirone 15mg/Melatonine 3mg led to neurogenesis in hippocampus, an effect similar to anti-depressants. E.g. Guanfacine at bedtime Buspirone and melatonine in the morning
@@DrJohnKruse I think FDA, because of a huge demand, removed Buspirone from pharmacies in US, but not for effectiveness nor side effects reasons (buspirone is in usage for the last 50 years or so) as stated. Of course, pharma industry will be against it since together with melatonine it can be an efficient antidepressant with practically zero side effects. Taken alone, it is prescribed for GAD only i.e. it is too weak for SAD. Some patient report Guanfacine 1mg has a better effect than 3mg, is that your experience as well? I'm just thinking that a combination of Guanfacine 1mg, Buspirone 15mg, and Melatonine 3mg could be helpful to many patients, especially HSP high risk hypersensitive individuals as well as those on ASD spectrum.
The studies I have seen only looked at a few children on extended release guanfacine, and found only small changes. This is something worth keeping an eye on, but clinically the majority of people with ADHD I have worked with who took guanfacine felt that their sleep was more restful or longer on guanfacine.
Nope. Although most people respond in the 1-4 mg range, we know that some individuals will need more than this, and some will get actual improvement from less. Just as with stimulants, humans show a lot of variability. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-UWdWreiH-9s.html
I stopped taking mine and have more energy now. Otherwise it didn’t seem to be helping at all. Gonna try 5htp and just stick to taking an adderall for the occasions that call for it. Seems like every psychiatrist is looking for a constant fix instead of a temporary form change as if I don’t have strengths while sober too
Why do I get insomnia from intuniv? Is that a temporary side effect that will go away after a few week? I just lie in bed and my brain juat wont get to sleep even if my body is completely relaxed(I listen to guided meditation). I like how I feel on intuniv and really want it to work but I just can't sleep. Does melatonin Interact with intuniv ? Regards
@John Kruse i have only tried to take 1mg intuniv in the morning and could not sleep at all without sleeping pills.. i took it for 4 days before i gave up and it took me 3 days to be able to sleep as i do normaly even if its far from good sleep i have.. where i live there is only intuniv, by splitting it it should be exacly like a quick release right ? im extremly sensitive to medication and thinking about trying again with intuniv but only take it every otherday or something like that. to explain how sensitive i am i got 20mg vyvanse a few years ago and knowing my self i split it and took only 10 mg and im glad i did cus even that was way do much for me and i was high all day took me a few weeks before i could up the dosage on vyvanse to 20 mg. its like my body is super sensitive and respond TOO much to medication and even alcohol so i dont even drink and when i do i only drink 4-5 beers and that is more than enough to last me all day. Spliting 1mg intuniv into 4 would make it quick release as (tenex) ? maybe i could try that and take 1 or 2 a day until i adjust to it and can take the whole 1mg pill. and before you tell me to talk to my own doctor please dont... i have tried and they dont listen or understand how sensitive i am. i need to get this medication to work... im desperate. Regards
I’ve just started Guanfacine. The first pill made me feel really chill. Now my body is getting used to it while I go up dosage. I was on Dexamfetamine, although it was great when I was well rested it sometimes made me really snappy. I have a comirbid sleep disorder so it was rare I’d get the max benefit from Dex. What are your thoughts on Combination therapy. Stimulant and non stimulant together?
It appears that a majority of those taking guanfacine for ADHD are taking it in combination with another medication, most often a stimulant. Some research indicates that the guanfacine can help make stimulants more tolerable for those prone to overactivation or anxiety from amphetamine or methylphenidate products. I've worked with a number of people with good responses to the combination.
My child, age 5, is taking this for severe ADHD. I never thought I would put my child on medication and was very hesitant to start him on Guanficine. After a few weeks, I saw a night and day difference in him! He is now able to focus on tasks and calms down easily. Before he would have tantrums that would last up to 2 hours and I would have to hold him and rock back and forth to calm him down. He also used to talk about cars/car wheels all day long, but now talks about many topics. We are thinking he may be on the spectrum, but so far the doctor thinks he has ADHD. This medication HAS been life changing for my child and he seems so much happier on a daily basis. My only concern (and probably many other parents' concern) is what will this do to my child long-term? No doubt his quality of life has improved while on this medication, but long-term will this medication do any damage or change the way he grows mentally and physically?
@John Kruse - thankyou for this response. Our therapist recommended this for our 7year old and this is my exact concern with medicating our child. However the quality of life for him and our family is so miserable, it feels like a "condemnation" to keep medicine from him.
Hello. I hope your child is doing well. I've been looking into Guanfacine for my child because stimulant ADHD med (Concerta) lower his appetite and he isn't eating well. He's 9 and he's only between 15% to 25% on the growth chart. Did your child take Guanfacine at night? Did your child's appetite improve on Guanfacine? Thank you.
@@lania3717 All experiences are different of course...but honestly his appetite didn't change at all. The first 24 hours he was very fatigued; but after that there were no appetite or sleeping issues. About 1 month in, the doctor recommended we increase the dose since it didn't seem to do anything at all. When we increased the dose he had 24 hours of fatigue, and then back to normal. We stopped the medication 1 week after increasing the dose per our doctor when he was experiencing the biggest meltdowns we've ever had.
I'm not aware of any head to head studies. Clonidine is substantially more likely to cause dangerously high hypertension if someone stops abruptly or misses a dose, and given that individuals with ADHD are more likely than the average person to miss a dose, I almost always would try guanfacine instead of clonidine.
@@jatinsharma5024 I know that there are reports of being used effectively for Tourette Syndrome, but I don't a have any direct clinical experience with it in that context.
Yes. Officially there is one condition (ADHD) with inattentive, hyperactive, and combined (both inattentive and hyperactive symptoms) types. Several inattentive symptoms have been found to respond to guanfacine.
@@DrJohnKruse thank you. My 21 yr old son may have tic-related OCD and he maintains that his thoughts are just random. No visible compulsions. He is sometimes stuck unable to move for hours. I think they’re mental tics or perhaps it’s ADD. He was sometimes inattentive his whole life but never diagnosed with anything. High Zoloft didn’t work, nor did anafranil. Half a zyprexa could be working a bit. His doc wants to try Luvox but I’m dubious . But his doc and I have talked about Guan
@@michelevanhulse9339 I haven't examined your son, so I can't make specific recommendations, but in general, if two different drugs with strong serotonin reuptake action (sertraline/Zoloft and anafranil) haven't helped, I would be more likely to try something else, like guanfacine, rather than one more SSRI like Luvox.
@@DrJohnKruse I agree. But can he try guandacine while on 100 anafranil because it will take long to wean. Or will the guanfacine efficacy be masked by anafranil ?
@@michelevanhulse9339 again, I can't make specific recommendations, but I can say that many people who take guanfacine for ADHD are simultaneously taking stimulant or other non-stimulant agents. Most of my patients experience gradual improvements with guanfacine, which can be masked if other medication changes are occurring at the same time.
@@DrJohnKruse Perhaps you might benefit from joining Toastmasters? Your message is invaluable. More folks can improve their lives from your speaking if you are more comfortable projecting.
