My problems are loss of appetite, trouble sleeping (leading to sleep deprivation that itself causes loss of executive control), and irritability. This is in addition to the fact that I have high blood pressure, and would rather not have to increase the cocktail of medications that I'm taking for that.
Believe one of the brands is called Intuniv.
It certainly seems better for me than a stimulant.
Can you elaborate which ADHD symptoms it has helped the most? I'm currently not taking any meds but I can't focus or concentrate to save my life which makes a demanding IT job difficult at times.
I had already achieved quite a lot in the way of symptom management through cognitive behavioral tools and physical exercise, but consistent application of tools and discipline broadly are exactly what ADHDrs often struggle with. Clearly, it's problematic to rely on a treatment for unreliability which is itself unreliable. So good results, but inconsistent.
The guanfacine has been much more stably effective at reducing the general baseline tendencies. For me, like I said, it was a miracle, since like you, but for a different reason, I can't take simulants.
I've noticed that stimulants can make me hyper-fixate, which often times, can be very beneficial. I relied on hyperfocus prior to being medicated, and it seems like medication is just a on switch for hyperfocusing. At least, some of the time...
Guanfacine is approved to treat ADHD in the United States and several other countries.
Technically, extended-release Guanfacine is approved because that's what was used in the trials. The brand name is Intuniv and the generic is Guanfacine ER.
The generic guanfacine (non-ER) can also be used, though technically off label. The only difference is that it must be dosed twice a day instead of once a day and the absorption is different so you can't do a 1:1 translation of your dose to the ER.
Now that Guanfacine ER is generic and cheap, you might want to consider it for once daily dosing.
The non-stimulant medications are very good, but require some patience to get started with. Too many people give up in the first week or month because the side effects haven't settled yet. Straterra (Atomoxetine) is another one that can take 1-2 months for good efficacy. Clinical trials show the positive effects continue to build over the course of a year. Surprisingly, Atomoxetine has a lower relapse rate after discontinuation too, suggesting it might be making some long-term positive changes to the brain. This is a nice contrast to stimulants, where the patient becomes essentially dependent on the medication and can go through a protracted rebound if they ever have to discontinue.
One reason I have never considered the blood pressure medications is because, and correct me if I am wrong, if one takes them too consistently for too long, then sudden cessation can be dangerous and/or deadly.
> The non-stimulant medications are very good
Define very good. From what I have gathered during my browsing of research papers of varying quality, it seems that that non-stimulant options are perhaps at the level of "better than nothing."
If I remember correctly, those who do well on MPH tend to do better on Atomoxetine, but even then, it's no guarantee. I've also read plenty of anecdotal evidence from people using Atomoxetine, and it seems like a large majority either cannot even make it past a few weeks due to intolerable side-effects.
Also, the wikipedia page for Atomoxetine is not very reassuring with the statement:
A 2020 meta-analysis found that atomoxetine was associated with anorexia, weight loss, and hypertension, rating it as a "potentially least preferred agent based on safety" for treating ADHD.
What I really want to see if more head-to-head drug trials with all these medications and non-pharmaceutical alternatives.
For example, how much more effective on average are stimulants than non-stimulants? Are things like caffeine, nicotine, or both combined more effective than non-stimulants? What about compared to stimulants?
All I can ever find is research supporting if a medication is successful in reducing symptoms compared to a placebo. I just want to see them all ranked against themselves. Of course, I understand individual experiences would vary wildly, but I do think there is a potential for some utility in this data.
Even getting in a small argument with my kids would increase my heart rate and blood pressure to unsafe levels. However, it did help me focus and pay attention, it also helped me kick my Marijuana habit (Legal state) which looking back just fueled my ADHD symptoms. It was also being used as a crutch to avoid dealing with my emotions and problems in life which just added to my anxiety.
Going back to the studies, another issue is that these medications can vary wildly from person to person based upon our own perceptions, experiences, and other comorbidities combined.
Like lots of medications, you really do just have to try out several until something works well with your particular body.
I wasn't aware of the long term positive changes, perhaps this is what my psych should have said instead of giving me an analogy of floating down a river and wanting me to carry on down that same stream without the meds...
This needs more context, because unlike stimulants, you can't quit guanfacine instantly or you'll feel pretty ill. You have to taper off it for a week or two.
Also, you can't drink on it (enjoyably) and it made me feel tired and emotional.
Just want to warn people here. Follow-up warning: Don't trust psychs. Much like cops they're actively trying to ruin your life.
"ADHD types" as I understand, are pretty controversial. If you're going to say that one "type" should not get medicine for a morbid condition, you should have a good reason.
What happens is a substantial percentage of people with ADHD get hurt by a system that uses them, chews them up, and spits them out with nothing, after taking every cent they have. Often times, we die from associated conditions, so it just gets swept under the rug. The industry isn't exactly searching for answers here, so their death is in vein, which infuriates me.
This is a known problem that I'm talking about, because I want it to change. Healthcare for people with ADHD is openly bigoted, degrading, and often harmful.
I'm astonished that despite all the news, conditions for people with ADHD are as bad as ever, and maybe getting worse. I think there's an interesting link to the trans community as well, since some of the psych issue overlap.
It may seem that trans have it better than ever, but they're up against whole armies now. There may be acceptance now, but I can imagine it being even harder to lay low. Mental health is less taboo, but people with ADHD are increasingly being marginalized, told to just give up on their aspirations, and accept life being disabled.
The worst idea ever is assigning them "monitors". The kid is in a classroom that goes too slow to hold their interest. And there is an adult whose job is to torture them with reminders to return to task every time they get distracted. Guess how well this works? And yet it is a standard IEP intervention used across the country!
For less than the cost of adding the monitor, you could move the same kid into an environment where they can learn at their own pace. Thereby saving money, having the child learn faster, and removing a major source of disruptions for the rest of the class. But we've literally passed a law mandating "mainstreaming", which makes the common-sense and effective intervention illegal unless the parent pays for it out of pocket.
But that is a rant for another day.
Eat the rich I say, then we can start solving some of societies problems. Until then we are all just walking dollar signs, I imagine ADHD is particularly profitable to companies due to our impulse purchases and lack of executive function.
Great fodder for the criminal industrial complex too.
In my personal experience, my current behavior health provider (which is not a psych) has been very interested in trying to find whatever works to help me get along in this world, be it medication or not. Maybe I got lucky there.
I've always been gotten the impression that ADHD is just another hurdle in my life and that I just have to work harder than more neurotypical people to achieve the same results.
I am curious to know about what age range you are in as I wonder if this is also a generational / parenting difference? I am almost 40 myself and see many hurdles and issues that my kids are facing nowadays which I can't even imagine sometimes.