We have experienced the same thing in that it has really taken a while to see the results from the guanfacine and I have been thinking too of the best way to reduce this med. if necessary for my dd. When raising the dose, I found that going in 1/4 mg increments caused a lot less side effects than 1/2 mg increments. I might try cutting it just by 1/4 instead of 1/2 for about 5-7 days each dose change.
I'd love to hear from anybody stopping this med too re: any side effects when stopping.Thanks and good luck!
I'd love to hear how reducing/eliminating the guanfacine goes for you because I have a feeling I will be reducing my dd's later this summer too.
This write-up will be long, so I'll summarize my dilemma first. If it took 3 weeks to start seeing a medicine's benefit, will it take 3 weeks of lowering the dose to see if it's truly no longer helping? Here are all the details so you know what I'm talking about.
I haven't had much time to post here lately, but I know a lot of folks on this board have used guanfacine (Tenex). I posted a long time ago that my child was one of those rare kids whose REM sleep was getting messed up by the guanfacine, and it was causing overnight awakenings (this is his dr.'s explanation why it was happening). He began sleeping well when we moved the PM dose back to 3 PM, and things stayed good for awhile. However, a couple of months ago, he started having sleep issues again. The dr. had us try sustained-release melatonin. That helped some, but we're still having issues w/ overnight awakenings or just starting the day at 4 AM. Espec. since the guanfacine no longer seems effective at controlling his impulsivity after the stimulant wears off around 6 PM, we are experimenting w/ phasing out the PM guanfacine dose. Raising the guanfacine dose isn't an option given the sleep problems he's already had due to this med.
That's the background info. Here's my question. The dr. said that we should give him 1/2 mg in the afternoon for 5-7 days, and then we can eliminate it entirely. This is a med. that you need to wean off b/c otherwise your blood pressure can go haywire. I recall that it took about 3 weeks at 1 mg to see the benefits of the med. in terms of controlling ADHD symptoms after the stimulant had worn off. Does this mean I should stay at 1/2 mg for the PM dose for 3 weeks? I'm not sure I'll want to eliminate the med. entirely if we're getting some ADHD control from it in the evening. However, I'm also eager to be finished w/ this med. quicker if it'll get him sleeping better and we aren't getting any ADHD control anymore.
So, should I keep him at 1/2 mg for 3 weeks or just 1 week? Dr. said this isn't clearcut, and it's up to me to do whatever I'm most comfortable doing. Looking forward to hearing people's opinions!
Mom2ADHDboy39592.789849537I would go from 1/2 mg to 1/4 mg then stop it.