How many mg did yall take?
Positive effects?
Negative effects?
Im concerned that it does nothing
Hi,
usually the dosage is from 1 to 4 mg / day.
Starting with 1 mg and slowly dosing up.
Important: a dosing of guanfacine should be closely monitored by a doctor who keeps an eye on your blood pressure.
Guanfacine should also not be stopped suddenly if you are taking a higher dose, as this can lead to a hypertensive crisis.
Please discuss all of this with your doctor.
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Hey I went to 3 mg but now I’m at 1 mg again and getting off it 
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There are quite a significant number of people who take it either alone or more often at night to reduce stimulant insomnia and add therapeutic benefit the next day. So, there is quite a lot of examples of benefit. Plus to be approved by the U.S. FDA for ADHD it had to prove effective in clinical trials so there is also the medical backing in that regard. I’m guessing you’ve tried it by now. But may or may not still be titrating, or steady on a dose, or quit? It is worth a shot as if it does help, that avoids pitfalls and side effects of the other options.
I am probably not the best example as when I started it, it was after I had damaged my brain with high dose Adderall to the point of being disabled and unable to work anymore. I had been off meds for 2.5 months then tried guan for 3 weeks. For me it sucked. All side effects, no benefit. Mind you at that time 40 to 60 mg Adderall IR (good brand like Teva) + 400 mg modafinil + 300 armodafinil + 100 mg strattera + 200 mg caffeine was my minimum to feel comfortable driving. But still was long ways from truly working. With my extreme tolerance, damaged pathways and endocrine system (people aren’t informed just how bad that can get for those sensitive to the side effects of amphetamine), not much chance it would have been therapeutic. So, all side effects, no therapy. Also note I have SCT and narcolepsy which both make me extra sensitive to anything with even a slight sedative effect. Even before the whole destroyed my brain and endocrine thing.
Also Note: Guanfacine XR (Intuniv) approved for ADHD, is only 60% as bioavailable as the IR (forgot the branding) blood pressure version. With the long half life, either could be taken. I was prescribed IR. IR will have a stronger peak effect, as well as stronger as it provides more to the system. IR may have a stronger sleep benefit taken before bed, but more likely to wake you up early due to the 5 hour or so peak effect. But, all depends on how you respond. Need more sleep induction and don’t get woken up early, IR. Wan’t a smoother steady dosing or do get woken up taking it at night. XR. Or, shift time of day when taken. I take mine most often in the morning. But sometimes take it middle of night to help fall back to sleep and the peak will be after I get up and take my other meds anyway.
Side effects (everyone responds their own way. Was off other meds except I think very low dose modafinil that can help repair some Adderall damage and low dose strattera to counter persisting Adderall side effects.):
–More sleepy, less energy
–Stomach was a little off, but not to the point of nausea
–minor heart palpitations (common as it literally is a repurposed blood pressure medication. It increases one of the timing to reset mechanisms for some part of the heart. Which the body may increase heart rate to make up for it. Which may have contributions from Cialis taken for Adderall side effects. Which is also a repurposed heart medication, for boners and BPH symptoms 
–Could decrease sleep. As I think it would peak in about 5 hours, which woke me up early and not able to fall back to sleep. Ironically, the SCT makes me extra sensitive to stimulation at night. Changing the dose timing of it was how I managed that.
–My use for it is literally the only time at that point someone had used it with the same purpose I did. As such, I had experimented. Had gone up to 6mg. Did have slightly more benefit at each increment. And had to deal with the temporary sedation each time. But, didn’t feel it gave enough benefit at each increment to to justify potentially causing more tolerance. And higher chance of issues if I took something that is contraindicated with it by accident. This was all done with guidance from a neuropsychiatrist.
–Other drugs or supplements that affect the CYP3A4 enzyme can potentially affect guanfacine which is metabolized by it. Body I am guessing can handle another drug or 2 that reacts with it in some way. Just in case, I’m mentioning it.
As I took 5 including guan that are metabolized by 3A4 and a 6th medication that is a potent inducer (increased activity) of it. As is 1 of the other 5 (potent inducer). And some supplements that affect it. When I started the 2nd potent inducer, that is when my simvastatin cholesterol meds stopped working and had to find a different statin after my cholesterol doubled from it.
If you want to know how guan works for ADHD:
Simple version: closes HCN and KCNQ channels in the prefrontal cortex which increases signalling efficiency. Easier signalling, more signalling, stimulates the functions of the PFC. Like executive function, concentration, memory, etc. This is one of norepinephrines (NE) jobs. Guanfacine is stronger at it. The receptors activated act as autoreceptors (feedback loop) and shut down NE release. Checks and balances naturally. Guanfacine doesn’t get shut down by the autoreceptor, hence its ability to more strongly influence the PFC signalling efficiency.
If you’re a masochist and want to read more poorly written stuff… detailed version (ish) by a non professional Google based knowledge: guanfacine works by literally doing one of the functions of norepinephrine, just stronger than it. An alpha2a-adrenergic agonist. In the front of the brain, it prevents adenylyl cyclase from making cyclic adenosine monophosphate (cAMP) there. Normally cAMP activates protein kinase A (PKA) which has a phosphorylation fetish that results in the HCN and KCNQ channels being opened. When opened in the PFC, there result in na+ flowing into the cell and k+ ions out, makes signalling very hard. Blocks the constant signalling needed for higher order function like executive function, memory, and concentration. Acts like a brake, or throttle depending on how you think about the balancing function.
So guan causes the closing of the HCN and KCNQ channels in the PFC, which increases signalling efficiency, which is stimulating. alpha2a also works as an autoreceptor (feedback loop) and shuts down additional norepinephrine release from those cells. Does affect other brain areas that benefit things like anxiety and can modulate emotional responses. Calms activity in some places. Forget which place/s the sedative effect happens. Can find that easily on google. That is actually the high level basic explanation as the brain is much more complicated than people realize.
**This part below won’t relate to you but adds context to my experience. Can skip it.
Note, I was taking it for an experiment as I am one of the negative cognitive responders to GLP-1 based meds. (Big Pharma is trying to hide the fact that some people have the negative response while doing clinical trials for the positive responders as a second line med for drug drug resistant depression and anxiety).
Mounjaro alone shuts down signalling in my PFC (front of brain associated with higher order function) making all ADHD meds less than useless). Fried my brain with high dose Adderall unsuccessfully trying to overcome it before I figured out what big pharma was hiding. Had been off for 5 months before starting it again.
So, guanfacine sucked, mounjaro destroyed what Adderall accumulated side effects from 2007 to 2022 hadn’t quite finished off yet.
Guanfacine 1 mg + going back on mounjaro at the 2.5 mg pre therapeutic starter dose: within 12 hours no more guan side effects. Together they were actually the most therapeutic drug there could possibly be fore me. Less than a week, was able to leave home for first time with no Adderall (lower dose of other meds though). First break in anhedonia in over a decade and a half. But, it all got quirky as I increased my guan to 2 mg to see how it may differ from 1. Plus some other factors. Think optimally mounjaro may have been best even lower than the minimum starting dose. Which would need a compounding pharmacy to measure that. Also, a bunch of other factors I’m not going to get into. 2 years later, still on them. But have had a bunch of other factors affecting things that others are not likely to come across. Also, I actually do take Mounjaro for diabetes and it has had many other health benefits. Hence my stubbornness to find a way to make it work.
Currently take 4mg guanfacine IR and 5 mg Mounjaro, its first therapeutic dose after the 2.5 starter dose. Long story on that which includes experimentation that likely added some of the guan tolerance.
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Fuck bro. You know a shit ton, i have so many questions.
- Where did you acquire all that knowledge???
Im currently on 30 mg Elvanse and stopped taking the 3mg guanfacine. To sleep I take daridorexant. I didnt understand you regarding mounjaro? I dont know much about it but its not only a glp-1 agonist but also a GIP agonist. I didnt understand if mounjaro is bad for you or how it reduces the activity in the prefrontal cortex. Well I just understood that it reduces the activity there. And yeah obviously pharma doesnt talk about it, to make money. Retatrutide might be better but who am I compared to your intelligence hahah.
Im very very sensible to meds, i get strong side effects from freaking 18 mg concerta or 20 mg Medikinet. My hunger completely goes away with 30 mg Elvanse/Vyvanse.
Im really concerned about you saying that adderal fucked up your brain. How? I dont get it? Cuz of overdosing or cuz of adderall in general? Go deeper into that. Will talking elvanse also give me brain damage or what???
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[The simple answer is you probably won’t have to worry about issues like mine. Just need to pay attention and learn about what to look out for so you know if things are starting to cause long term side effects or not. GLP-1 based meds can be good or bad. More often good or neutral than bad. My meds are not doing all that well at the moment so a bit harder than my usual dysfunction to focus. ]
I did cover some very basic stuff in psych classes in college. But, vast majority I learned online reading research and putting pieces together. It was out of desperation that started me down the research path. Then finding actual answered to problems therapists didn’t even know about, which was the reason they failed me, made it addicting. Then the GLP-1 thing on top of it and finding a solution, albeit too late.
I took my Adderall / Dexedrine at or below my prescribe dose from 2007 to 2022. I only went over a handful of times for job interviews as the prescribed dose (60 mg) just wasn’t fully working at those times. Even then, neither was adding another 20 mg (80 mg total), but was better. Started at 30 mg which was more than enough to downregulate and damage neural pathways and my endocrine system. Most of the time I was taking between 40 and 60 mg. It was a steady increase in cognitive and endocrine side effects at any dose I was on. I did not expect to be able to make it to retirement.
It was going up to 140 mg trying to overcome Mounjaro that exponentially accelerated the damage and left me disabled. Mounjaro blocked signalling in the PFC. But did not block Adderall which damaged my brain with going from 40 mg that I had been taking at that point. Going 3.5 times that to 140 in the end before I couldn’t go on any more.
Most people as far as I know find a stable dose of ADHD meds. Lack of sleep was the biggest factor for me driving tolerance. But, you have that covered. For amphetamine, Vyvanse is the least likely to have long term issues. If you start having tolerance issues with Vyvanse or other amphetamine based medication, you can try adding Strattera or Memantine to prevent tolerance from NMDA/glutamate overstimulation resulting in damage to those pathways. Can take months to see the benefit of reduced amphetamine tolerance. If that didn’t help then those pathways may not be damaged by meds (assuming the case where you did have tolerance issues and had to increase meds because of it.)
If you have endocrine like those of high cortisol or pseudo cushing’s, that could be Vyvanse. (look up a few sources that list symptoms as never seen one that has all of them together)
Can also search on how amphetamine can affect the endocrine system and see if you have any of those.
Long term cognitive side effects can be things like not feeling sharp anymore even on meds. Anhedonia, low motivation, reduced focus. Avolition has hit me the hardest. I also had some GI issues where is slowed down stuff moving through.
If you just have side effects that are only seen when on it like blood pressure goes up. Then not a worry long term for issues like mine. But would want to attenuate the BP issue as that can have its own long term issues.
GLP-1 drugs can be positive, negative, or neutral for cognition. It can be totally different for people even with the same disorders and symptoms. For some people it might not cross the blood brain barrier and enter the brain. Which may explain the neutral responders. For others, it has both positive and negative effects on cognition at the same time. And the net result of the dominant effects for a person is what we see in the end.
GLP-1s can have huge benefits. I have been back on mounjaro for 2 years now, even after I ended up disabled cognitively trying to overcome the negative response I had by taking very high doses of Adderall.
Think of it this way. On one hand, they increase neurotransmitter release and make signalling more efficient. Which is stimulating.
But in the Pre Frontal Cortex (PFC) where higher order cognitive function is based. It can block the signal between cells. Which, the way it does it, is also what guanfacine attenuates to improve stimulation. Can think of the negative responders as having a reverse guanfacine effect.
For some it’s the best thing they ever tried. I’m unfortunately the polar opposite side of that. Mounjaro took GLP-1 and added GIP agonism. Which the way they did it actually increases cAMP better than GLP-1 alone. Which is why it is stronger than Ozempic that is GLP-1 only. Retatrutide ads glucagon receptor agonism to Mounjaro’s GLP-1 and GIP. Which like GLP-1 and GIP use cAMP to signal the cascades of functions. But the result is having some same and different aspects as Mounjaro and Ozempic. Van’t say for sure, but I would guess it may have the same cognitive pitfall of earlier GLP-1 based drugs too. But may get lucky and somehow elicit different net reactions to it.
People vary a lot in how sensitive they are to side effects of different medications. Adderall for me damages my brain at moderate doses. Haven’t tried low dose before as I started on medium dose due to incorrect equivalence guide that only works for starter doses.
“Im very very sensible to meds,” Think you mean “sensitive”. It depends on what side effects you are having on how to characterize them. There are side effects which can be neurological, endocrine, digestive, etc. Then there is tolerance.
The important thing is how you respond. And to recognize issues if/when they come up. My brain gets going too often and I probably wrote way to much in these replies, which can be confusing.
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I dont quite get, how and what did you damage in ur brain? I suppose the high adderall dose was the cause of it. Am I at risk with 30 mg Vyvanse and would going up in dose give me a higher risk? I want to understand if me taking vyvanse is still somewhat safe?? I suppose ur just a rare case due to overdosing, right?
I’ll try to give a simpler answer.
I can’t be sure how you would be affected long term. Chances are you would be fine even going up a dose.
People can vary a lot in their response. Most people are stable on a their dose. If you have increased it and it worked for a while. Then had to increase it. And done that more than once then you may need to work on managing your schedule and habits to stay stable on a dose. Getting enough quality sleep is critical. Sometimes the meds still work but your brain adapts and starts letting more distractions through again. In which case it is better to try non-medication therapies to manage first. But if you do keep building tolerance, you’ll want to get that managed and not keep the cycle going.
Your resulting dose of amphetamine from 30 mg Vyvanse (Elvanse) is about equal to 12 mg zenzedi or 14 mg Adderall. Plus, since it is Vyvanse, it spreads out the release and keeps the blood concentration much lower so less potential to be an issue long term than what I was taking.
Adderall had ruined my life between 30 and 60mg a day. It would have done so at lower dose too but was started at 30mg Adderall XR due to therapist not understanding cross tolerance correctly. Long before I had the dosage escalation issues caused by Mounjaro.
If tolerance becomes an issue, or if you start having endocrine issues. Like Low testosterone or estrogen dominance. Or trouble with high cortisol symptoms. Then you may need to move to another medication.
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Okay and I have other questions.
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How do you know that the meds destroyed your brain pathways etc.? Did you get more stupid or how?
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I had a phase without adhd meds a few months ago and I got into tulpamancy and then the voices became realer and realer and I also got bad voices that scared me a lot. I could/can differenciate the voices from a real human voice and the voices arent thaaaat real, though at night they do get pretty real. Now since im taking adhd meds again, they have been gone. This shows that im not schizophrenic since adhd meds alone wouldnt make them go away if i were schizo. I also got prescribed olanzapine but im not taking it since studies show that the shit eats up your prefrontal cortex, so yeah no thanks!
My question is: Are you able to find any correlation between the adhd making the voices go away??? -
My therapist and psychologist arent believing me and my therapist just said that its from hyperalertness. They dont believe anything I say and they even ghost me!!! Im having a hard time trying to change the clinic. Hopefuly I can, any advice?? I cant tell my parenst about the voices, they will freak out if so…
Best regards
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- Cognition declined and hadn’t felt sharp in years. Also caused things like anhedonia, lack of motivation, avolition, lack of energy, etc. Was a steady decline taking between 30 to 60 mg from 2007 to 2022. Then over the course of 10 months trying to get around what turned out to be Mounjaro blocking PFC signalling, I had increased to 140 mg that exponentially accelerated the damage. (again, not everyone has a negative cognitive response to GLP-1 based drugs). Leaving me disabled and unable to work. Then off for 4 months and an ultimatum to go back to work or lose my contract position. Then gave up trying to find a therapist for answers and self medicated based on research I found. And managed to make myself functional again on a vastly superior combo of meds. But with the high existing tolerance and damage done to pathways. It just picked up from where things left off and started escalating my dose for 2 more months which did more damage and again disabled, but worse off. Wouldn’t say I was stupid. Most stuff I posted I figured out during the ordeal or after. Memory is not as good and if things get to complex my brain shuts down. Takes more repetition to learn things that I can manage. Also, quite noticeable is it is hard for me to organize my thoughts and plan what I am going to write. I have a thought, I write it. It elicits another one. Often going back to stick a though in somewhere when it comes to me. Unplanned, unorganized. Just stream of consciousness. Doesn’t work well for complex tasks that require planning and steps to work through.
Avolition makes goal oriented tasks difficult to start and see through. Can’t maintain a regular sleep schedule. As a software engineer writing code and figuring out new things, it is all brain all day. I struggle to focus, lack alertness and working memory capacity, etc. Easily find myself off task without intending it. Lots of things end up unfinished. Like the 150 or so chrome tabs I have open across a bunch of chrome instances.
Meds, especially amphetamines, can also mess with the endocrine system. Which I was able to see on blood tests. Which just makes things harder and ads more symptoms to deal with. Hypothalamus sits on top of the pituitary gland and makes some hormones and directs the pituitary gland and dozens of immediate and downstream hormones. Which also influences the brain. Neurotransmitters affected by psychoactive meds modulate hypothalamus activity so it is easy to see the connection when thinking about it that way. Have to watch kids on meds for stunted growth. Well, they just ignore the other dozens of hormones affected by the hypothalamus. FDA prescriber doc does say amphetamine can raise corticosteroid levels and be highest in the evening. Well, supposed to be lowest in the evening and highest in the morning. Take meds in the morning and instead of cortisol (primary corticosteroid) going down, it can go up instead. If you looked at symptoms for chronic high cortisol levels and pseudo Cushing’s disease. You can see many more potential long term side effects. People stable on low dose would be less likely to have issues. 30 mg Adderall XR was way more than enough to damage both my brain and endocrine system.
- I had to look up tulpamancy. I’ve never had issues with voices or hallucinations fortunately. I can believe what you are saying though. Twice in my life on being woken up I observed myself talking to my father. The “me” consciousness and inner voice was like “wow, this is weird, wonder what I am going to say next”. Literally was not controlling or participating in the discussion, but instead was a 3rd person listening to myself have a conversation with my father. Literally had no idea what I was about to say.
The mind is a powerful thing. There are warnings about medications causing psychotic episodes. More likely to happen for children but can happen to adults. I do know that I suffered depression until I was 23 which my own brain caused the deep depression and changes to brain chemistry just by having negative thought patterns. Had experienced occasional dissociative episodes where I felt like I was a passenger in my own body. I was in control, but felt disconnected from the real world. Which when I looked into it years ago is not as uncommon with ADHD or depression as I was expecting it to be. I also fixed my life long depression the week I started college and stopped making excuses and negative thought patterns and actually excelled.
Tulpamancy though. Brain may still have not normalized fully since last taking meds which may affect how the practice goes. Have to consider that for it to work, you have to actually induce physical and regulatory changes in your brain. I am honestly guessing about factors related to Tulpamancy. Just pointing out some things to think about which may get across the complexity of everything involved.
Maybe think of it like tripping on acid. The “trip” will depend on your state of mind going into it. Not in the right state of mind, can result in a bad trip. Tulpamancy, having some pathways not up to par, no way of knowing how that might go and potentiate changes in the brain. Plus ADHD is a hypofunction disorder to begin with which has under performing pathways from the start. I am only guessing as I don’t actually know how it can relate for sure or not. But, it could be possible that underlying conditions could make it more challenging to work as desired. Remember, each function in the brain relies on many pathways all working together. And many various neurotransmitters, secondary messengers, nutrients available, kinases, gated channels on the membranes of cells and mitochondria. Hydroxylases, catalysts, electrolytes, RNA and DNA and mRNA expression, and a whole lot more beyond my comprehension. These pathways and factors are both stimulatory and inhibitory and both are happening at the same time. Might have been the wrong timing to try Tulpamancy. Or may not have had the guidance available you needed.
There are other ways people induce an altered state of mind and is a part of ritualistic activities. There are also certain cultures and religions that have a large focus on the power of the mind and body. Some practice being self aware and controlling their dreams. In Japan, they are know for martial arts. But there is a difference between a martial art like Karate and the way of the martial art like Karate-Do. When they end in “Do” it indicates it is an all encompassing lifestyle built on philosophical and spiritual practices. India often has gurus who have mastery of some discipline or whatever and guide people etc. Sometimes these things are referred to as a “discipline” for a reason. So, the power of the mind and body is well documented and out in the open. But western cultures, it is not so much practiced or even accepted. I don’t know your background so don’t know if you have a background with cultural spiritualism or disciplines etc. Or if Tulpamancy was your first experience with mind and body oriented things.
One thing that is kind of funny though. Took till 2024 to find a therapist with the right background ( both neurology and psychiatry and works with people stuck on high dose meds and no help from other therapists.) He needed additional education and understanding the science of the brain to be the only person I found who could work with me. But, he also provides spiritual guidance as part of his practice. He I assume has an Indian background. I never asked for sure but definitely from the same region otherwise. Now, I have been a born again atheist since first grade and have zero spirituality, nor believe in any way in anything supernatural. So, I don’t utilize that aspect of his practice. But, do still believe in the power of the mind. I had influenced my dreams a little here and there. I could always become aware and purposely wake myself up if having a nightmare. Till one day I woke up and was like, wow, that was so cool. Then realized I love horror movies and sci-fi and began to think of nightmares as free horror stories so didn’t bother to wake myself up. Then my nightmares switched to being in school and unable to remember where my locker is. And forgetting what classes I have and not able to find them. Basically undoing the part of my life that turned everything around for me and made me successful and excelling in life. Haven’t been having the nightmares much anymore. Just realizing now it is probably because I’ve been living it for so long.
With the ADHD meds, they may have strengthened certain pathways or connections that were able to attenuate or suppress the voices. Schizophrenia is just one of a number of disorders or states of mind that can cause a person to hear voices. I wouldn’t get too hung up on Schizophrenia.
Since Tulpamancy was a cognitive exercise you had to practice, and not triggered by a psychotic episode or delusion. And you remained aware of what was real and what wasn’t. And it resolved when going back on ADHD meds…
Question is, are you sure you still need to change the clinic? They can still treat ADHD even if they don't believe you about Tulpamancy and the issues you had with it. Since it seems to be resolved with the ADHD meds. I would expect the changes you caused in your brain will normalize over time. As long as you stick to the regular voice in your head and try to suppress the temptation to engage Tulpamancy. If it is something you still want to pursue. I'd recommend doing it with a guide who knows what they are doing. If any are available. I'd be weary though. Such as if these frequent medication shortages you found yourself out of meds. If you were practicing Tulpamancy while on meds. Then ran out. That would put you at a significant decrease of function that "may" cause a much deeper issue that could lead to a psychotic episode. (again, guessing)
I know all too well what it is like for doctors and therapists not to believe me. Only to find out the research already exists. Other times, other therapists are already doing the thing they don’t believe. The worst is when a therapist is contradicted by the FDA prescriber document that is for them and comes with the meds they prescribe. I would literally double this reply if I tried to tell you all of the times I was dismissed by doctors when all the information was readily available. The latest, literally figured out a treatment for lymphomas and leukemias that the medical community is not aware of. Which has been treating mine for 3 years now. Just found out 2 weeks or so ago. Same mechanism they use PDE inhibitors for and studies they are doing with forskolin…turns out GLP-1 based drugs actually do it far far better than any of those and it is their underlying method of action responsible for all the things it does that people are aware of.
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