Is Guanfacine Good For Anxiety?

Guanfacine (brand names Tenex and Intuniv) is an alpha-2a-adrenergic receptor agonist.

 

It is used primarily to reduce high blood pressure in people with hypertension and as the most common treatment for mania in bipolar disorder, with some evidence that it may also be effective for major depressive disorder.

 

It can also treat traumatic brain injury, but its effectiveness is debated. Guanfacine has decreased aggression in prisoners, but this effect was only seen among those who underwent intense psychosocial rehabilitation before taking the drug.

 

 

 

Can you use guanfacine for anxiety?

 

Yes, guanfacine has been used with some success for the management of anxiety.

 

However, as guanfacine is best known for lowering blood pressure and may have psychotropic effects, you must talk to a qualified medical practitioner about any medications you are taking before considering taking guanfacine.

 

The recommended dose of guanfacine for treating anxiety disorders is 1.25mg, taken once daily with or without food.

 

Guanfacine can be used on its own or in conjunction with other psychotherapies (e.g., cognitive behavioral therapy) and antidepressants (e.g., SSRIs).

 

 

 

Can guanfacine help with panic attacks?

 

Guanfacine is not approved for the treatment of panic attacks or any other anxiety disorders.

 

However, it may be helpful for preventing or reducing the frequency and severity of panic attacks in people taking antidepressants (e.g., SSRIs), particularly those with comorbid hypertension and those with adverse reactions to antidepressants.

 

Guanfacine is most effective for improving anxiety symptoms when combined with cognitive behavioral therapy and antidepressants (e.g., SSRIs).

 

 

 

Does guanfacine help with anxiety in adults?

 

Yes, guanfacine helps treat adults with anxiety disorders. In particular, it may reduce symptoms of major depressive disorder and bipolar disorder (e.g., mania), especially in people taking antidepressants (e.g., SSRIs).

 

It can also possibly be used for the management of PTSD, but more research is needed.

 

 

 

How quickly does guanfacine kick in?

 

The therapeutic effects of guanfacine are usually seen within 3-4 weeks (i.e., when you start taking the medication). However, some people notice an improvement within a few days or even hours (i.e., when they first take the medication and when the therapeutic effects begin).

 

The more you take guanfacine, the faster your blood pressure will return to normal.

 

Some people’s blood pressure may not fully return to normal for a year or longer after stopping guanfacine.

 

For this reason, it is essential that you maintain a close eye on your blood pressure and keep yourself informed of any changes in it when taking guanfacine.

 

The prescribing information recommends that people taking guanfacine also have their cholesterol checked periodically.

 

If your cholesterol level is significantly elevated while taking guanfacine, you may need to stop taking the medication because this could be harmful to your health (i.e., hypercholesterolemia).

 

 

 

Does guanfacine have a calming effect?

 

Yes, guanfacine has been found to produce a calming effect in people with anxiety disorders because it can increase the activity of neurotransmitters that reduce anxiety.

 

The effects of guanfacine are magnified when combined with antidepressant medications (e.g., SSRIs) that also have mood-stabilizing effects.

 

It is possible that the calming effect of guanfacine can be enhanced by combining it with beta-blockers (e.g., atenolol), thyroid agents (e.g., Levothyroxine), or other anticholinergics like propantheline or bromocriptine.

 

Suppose you are taking guanfacine under the care of a physician. In that case, it is essential that you inform them of any medications you are taking with guanfacine to avoid any unintended interactions.

 

 

 

How much guanfacine should I take for anxiety?

 

No standard dose of guanfacine would suit everyone and every situation.

 

The prescribing information recommends starting with 1.25mg and gradually increasing to a maximum of 4mg daily if needed.

 

It is possible (but this has not been proven) that some people may notice an improvement in symptoms by taking lower doses than recommended (i.e., 0.5mg to 1mg daily).

 

To find out what dose works best for you, try several different doses and see which one provides the most relief and causes the fewest undesirable side effects.

 

 

 

Who should not take guanfacine?

 

Guanfacine may not be safe for everyone. It is known to have a narrow therapeutic window (i.e., a slight difference between the effective dose and toxic dose) and must be used with caution in people with:

 

heart disease or a congenital heart defect;

 

severe kidney disease; or

 

a history of mental illness (e.g., schizophrenia, psychosis, bipolar disorder).

 

In these people, it may be necessary to reduce the dose or stop taking guanfacine altogether.

 

You must also inform your physician if you are taking any other medications.

 

 

 

Should I take guanfacine with food?

 

As guanfacine has powerful effects on blood pressure, it can cause nausea and headaches when taken without food.

 

In some people, taking guanfacine with food at the start of therapy may make the first few days of therapy particularly difficult, but this effect usually wears off within 4-14 days.

 

Therefore, you should take guanfacine with food, but if you have any problems with nausea and headaches, please discuss these with your doctor.

 

 

 

Does guanfacine interact badly with other medications?

 

Due to its powerful effects on blood pressure, guanfacine can interact badly with some other drugs. It may not be safe to start taking it if you are already taking:

 

antipsychotics (e.g., haloperidol), antidepressants (e.g., SSRIs), or other antidepressants (e.g., venlafaxine);

 

thyroid agents (e.g., Levothyroxine);

 

beta-blockers (e.g., atenolol, propranolol, metoprolol);

 

antidiabetic agents (e.g., glipizide, glyburide) and/or insulin;

 

antibiotics (e.g., ciprofloxacin, penicillin); or

 

cimetidine.

 

If you are taking any of these medications or other medicines that interfere with guanfacine’s actions in the body (i.e., cytochrome P450 inducers), please discuss this with your doctor.

 

 

 

Can I take guanfacine with alcohol?

 

As the effects of alcohol magnify the effects of guanfacine on blood pressure, it is not recommended to drink alcohol when taking guanfacine.

 

If you are planning to drink, please discuss this with your doctor because they may need to reduce your dose or stop using it altogether.

 

 

 

How long should I take guanfacine for?

 

No evidence taking guanfacine for more than a year will have any health benefits.

 

Therefore, it is recommended that you stop taking guanfacine when symptoms have completely disappeared.

 

 

 

What are the side effects of guanfacine?

 

Guanfacine has been associated with the following side effects:

 

Drowsiness. Although most people find that this drug produces a calming effect on them, some report feeling drowsy. If you feel drowsy, try not to drive or operate machinery.

 

Discuss this with your doctor if you feel that the drowsiness is interfering with your quality of life.

 

 

 

Conclusion – Is Guanfacine Good For Anxiety?

 

Although guanfacine is generally well-tolerated, the side effects it can cause (e.g., drowsiness) may make it unsuitable for some people with anxiety disorders.

 

If you are experiencing many problems with the side effects of guanfacine, you should discuss these with your doctor. They may need to adjust your dose or change the medication you are taking.

 

Try a different medication altogether if these changes do not affect your symptoms.

 

This has been helpful for you to understand what guanfacine is, its uses, and its possible side effects.

 

Links

 

-https://link.springer.com/article/10.1007/s00213-012-2705-1

 

-https://adc.bmj.com/content/105/Suppl_1/A225.2.abstract