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.
Typical use: 1-7 mg PO daily (XR); titrate slowly — Rx.
What this is
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
Dose & route
1-7 mg PO daily (XR); titrate slowly
Citations
- https://pubmed.ncbi.nlm.nih.gov/27334405/
- https://pubmed.ncbi.nlm.nih.gov/19302148/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3037554/
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Guanfacine work?
- 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.
- Is Guanfacine safe?
- Guanfacine has a low-med risk profile in published human data. Legal status: Rx. This is not medical advice — see the disclaimer.
- What is the typical dose for Guanfacine?
- 1-7 mg PO daily (XR); titrate slowly
- 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.