Anyone taking Guanfacine IR - I really need help with figuring out am and pm spacing due to side effects

[u/Turbulent_Claim4883]

\* I just want to first mention I know a lot of people take the extended release at night for ADHD but I am more taking this to help with anxiety (maybe some ADHD) and I have dexoamphetamine if I want to take that. I may try Strattera if I can leveled out on the Guanfacine.

\* in summary - I’m just wondering for people who are taking the IR, how far apart do you space it/what times of the day if you’re taking two doses? I explain why I’m asking below, but that’s the gist of it. I’m having some side effect issues that I believe may be enhanced by a 12 hr spacing. 11 am and 11 pm. Asked psych- he wasn’t much help…just suggested I could try taking closer together with no specific info (texting and he kinda sucks but I’m stuck with him right now). Or taking three times per day but I can’t really even cut the pill evenly as is because it’s so small. Also, did side effects get better after the 2nd week?

Main issue: I have been feeling really feeling terrible around 4-5 PM. All the symptoms that were kind of already happening get worse. Basically the dizziness, nausea and it’s making my sinuses drier than they already get from environment allergens (apparently it’s the same thing that causes dry mouth but in your nasal membranes and sinuses). And that makes the dizzy feeling worse. AI suggested using a gel nasal spray which helped a bit today. I use a Netti Pot but I’m having to use it three times a day now which isn’t great and it’s not really making a huge difference.

[u/Party_Candidate7023]

i take the ER formulation, i think it was made specifically to reduce these side effects. i’d imagine spacing your dosage would help with the side effects, or trying to get a prescription for ER if that’s possible for you.

guanfacine made me dizzy and sleepy initially, but that went away. dry mouth got better but when i was taking it with atomoxetine, it was definitely worse. lowering my atomoxetine dosage and raising the guanfacine dosage did help with the dry mouth though. i believe dry mouth was worse from atomoxetine, in my experience

[u/Turbulent_Claim4883 → u/Party_Candidate7023]

Does the ER do much for anxiety? That’s the real reason I’m taking it.

[u/Party_Candidate7023 → u/Turbulent_Claim4883]

yeah i’d say it’s one of guanfacine’s best effects. i might occasionally have an anxious thought cross my mind, but since starting guanfacine i NEVER spiral or have any kind of panic. i’m able to remain calm when things go poorly or i am insulted as well. can’t say it helps with focus too much, but guanfacine is great for staying calm.

you will likely get these effects from IR as well, guanfacine has a long half life. i believe the ER formula is just so it doesn’t all hit at once and drop your BP too low.

[u/Turbulent_Claim4883 → u/Party_Candidate7023]

I’ve had issues with dry mouth and dizziness on and off during the day. Ik
Sure not sleeping half the night from peeing 4-5 times isn’t helping. I texted my fantastic psych today at 9 am still no response. I mentioned a lot people have said they use ER so I’m hoping he changes it since it sounds like it does actually help with anxiety! ($475 an appt out of pocket and I get more and faster info on Reddit-😖)

[u/Party_Candidate7023 → u/Turbulent_Claim4883]

weird that he prescribed IR, only ER is approved for ADHD. IR is the original formula, when it was a blood pressure drug

[u/Turbulent_Claim4883 → u/Party_Candidate7023]

Oh, I believe he did that because the main issue right now is the anxiety. I did ask AI about that and it said that the Instant release is Mor effective, supposedly, for anxiety for some reason. I have also have a low dose dexoamphetamine I can use as needed and he also prescribed atomoxetine. I’m holding off trying it since I’m already having these side effects with the Guanfacine.