Guanfacine
Cognitive · Alpha-2A agonist
Tier B+
Bottom line
Read Off Label grades Guanfacine as B+ (7.2/10) based on strong evidence, med benefit magnitude, and a low-med-risk safety profile.
Arnsten's work demonstrates unique PFC-strengthening action.
Studied, labeled, or reported-use context: 1-7 mg PO daily (XR); label titration is gradual — Rx; not individualized guidance.
What the evidence says
Arnsten's work demonstrates unique PFC-strengthening action. Non-abusable alternative or adjunct to stimulants in ADHD. Useful in tic disorders, PTSD-related hyperarousal. Extended-release formulation (Intuniv) is standard for ADHD.
Mechanism
Selective alpha-2A adrenergic receptor agonist; strengthens PFC network connectivity by closing HCN channels on dendritic spines; non-stimulant ADHD treatment
Studied, labeled, or reported dose & route
1-7 mg PO daily (XR); label titration is gradual
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Guanfacine's effects?
- Read Off Label rates the evidence for Guanfacine as Strong and the benefit magnitude as med, producing an overall grade of B+ (7.2/10). Arnsten's work demonstrates unique PFC-strengthening action.
- What safety findings are reported for Guanfacine?
- Guanfacine has a low-med risk profile in the database. Low-Med (hypotension, sedation, dry mouth) Legal status: Rx.
- What doses or routes are reported for Guanfacine?
- 1-7 mg PO daily (XR); label titration is gradual This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- How does Guanfacine work?
- Selective alpha-2A adrenergic receptor agonist; strengthens PFC network connectivity by closing HCN channels on dendritic spines; non-stimulant ADHD treatment
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.