Guanfacine for Adult ADHD: A Calm, Non-Stimulant Option

Quick take: Guanfacine (brand: Intuniv) is a non-stimulant ADHD medication. It doesn’t “speed you up.” It helps the brain’s prefrontal cortex do its job—focus, plan, pause before acting—by gently dialing down over-arousal. In the U.S. - unlike in Japan - adult use is off-label. 

How guanfacine works (in plain English)

Guanfacine stimulates α2A receptors—think of them as tiny “brakes” in the prefrontal cortex. That support helps with attention, working memory, and impulse control, without the buzz of stimulants.

What benefits can adults notice?

• Less reactivity and impulsivity (easier to pause and choose)

• Smoother mood and fewer outbursts

• Reduced physical restlessness

• Better sleep for some people

  These gains often build over a few weeks, not overnight. 

What does the research say for adults?

• A 10-week randomized controlled trial in adults found guanfacine ER reduced ADHD symptoms versus placebo. Most common side effects were sleepiness and lower blood pressure—usually manageable. 

• A 50-week follow-up study showed benefits could last, with the same predictable side-effect profile. 

• Recent analyses of adult ADHD treatments rank stimulants as strongest overall, and non-stimulants (like guanfacine) with more modest effect sizes.

Who is a good fit?

Discuss guanfacine with your prescriber if you:

• Don’t tolerate stimulants or prefer to avoid them

• Have anxiety, irritability, or sleep issues alongside ADHD

• Have tics or feel “over-amped” on stimulants

Guanfacine vs. stimulants (and other non-stimulants)

• Stimulants = biggest symptom impact for most adults, but not for everyone.

• Atomoxetine/bupropion = other non-stimulant options.

• Guanfacine = helpful when arousal, irritability, tics, or sleep are front-and-center—or when stimulants aren’t a fit. Combine choices with therapy, sleep, exercise, and structure for best results. 

FAQs

• How fast will I feel it?

Many adults notice changes over 2–6 weeks, with continued gains by ~8–10 weeks. 

• Will it make me too tired?

Sleepiness can happen, especially early on. Taking it in the evening, staying hydrated, and slow titration usually help.

• Can I take it with a stimulant?

It’s off-label, but yes!

Next Steps

• To discuss ADHD medication options, make an appointment today.

• Read client reviews.