Did Guanfacine stop working or did side effects increase as your kid aged?

[Anonymous]

DS12 has taken Guanfacine since he was 7-8 years old. It is the only medication that has worked for him and it has only worked to a certain extent. But we will take what we can get because otherwise he would be really miserable. For my sister's child, Guanfacine made him overly emotional beginning around the time he was 13. They had to drop it as a result. I also noted that Guanfacine's efficacy for ADHD is not proven after age 12.

Did declining efficacy - or increased side effects of Guanfacine -- occur as your child got older? If so, how did the change manifest itself? What side effects became more pronounced?

[Anonymous]

Anonymous wrote:DS12 has taken Guanfacine since he was 7-8 years old. It is the only medication that has worked for him and it has only worked to a certain extent. But we will take what we can get because otherwise he would be really miserable. For my sister's child, Guanfacine made him overly emotional beginning around the time he was 13. They had to drop it as a result. I also noted that Guanfacine's efficacy for ADHD is not proven after age 12.

Did declining efficacy - or increased side effects of Guanfacine -- occur as your child got older? If so, how did the change manifest itself? What side effects became more pronounced?

Was this from the STEPS drug review in 2011, in American Family Physician? It's outdated.

There is mounting evidence in Phase 3 extension trials that it is effective in adolescence and adulthood. The guidance probably will expand the age range in the next few years.

https://pubmed.ncbi.nlm.nih.gov/22610723/ (children and adolescent, 2012)
https://pubmed.ncbi.nlm.nih.gov/24139092/ (children and adolescent, 2013)
https://pubmed.ncbi.nlm.nih.gov/26506582/ (adolescent, 2015)
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02867-8 (adult, 2020)
https://pubmed.ncbi.nlm.nih.gov/34007156/ (2021)

[Anonymous]

Thanks for this! So emotional issues don't seem to be a side effect of Guanfacine in adolescence then?

[Anonymous]

My 12/13 year old took it for first time this school year. That is not a side effect we saw. The only side effect we dealt with was sleepiness. Unfortunately he can’t take it alone, needs stimulant with it to not fall asleep during the day.

[Anonymous]

Anonymous wrote:Thanks for this! So emotional issues don't seem to be a side effect of Guanfacine in adolescence then?

Do you mean as a common side effect across the kids taking it in research studies, or as something an individual might see, but not noted commonly?

[Anonymous]

Anonymous wrote:DS12 has taken Guanfacine since he was 7-8 years old. It is the only medication that has worked for him and it has only worked to a certain extent. But we will take what we can get because otherwise he would be really miserable. For my sister's child, Guanfacine made him overly emotional beginning around the time he was 13. They had to drop it as a result. I also noted that Guanfacine's efficacy for ADHD is not proven after age 12.

Did declining efficacy - or increased side effects of Guanfacine -- occur as your child got older? If so, how did the change manifest itself? What side effects became more pronounced?

DC did a trial of Guanfacine and stopped almost immediately because it caused extreme emotional volatility - for DC it was lots of crying and anger. This was age 10.

Assuming that the dose is also increasing (it’s based on weight) as your child is growing. The recommended dose is 0.05 to 0.12 mg/kg/day, so perhaps side effects due to dose increase? Or if you aren’t increasing the dose, you should for it to be effective as your child gains weight.

[Anonymous]

Yes, I am wondering if emotional issues are commonly seen across a variety of kids. Or if they occur in some individuals if not that common.

We are increasing the dose as he grows. He is currently maxed out at 4 mg.

[Anonymous]

We had emotional issues and switched to clonidine. It was a much easier ride.

[Anonymous]

Stopped working when he went into puberty. Did not have any negative effects, just ... no effect.

[Anonymous]

Interesting. I think this might be what is starting to happen with him.