This is exactly what I was looking for! I just couldn't see how/why a2A receptor agonism could yield both in increase and a decrease in norepinephrine; the fact that there are more postsynaptic than presynaptic a2A receptors the PFC makes sense! Thanks!
Wow, THANK YOU SO MUCH for the great article and visual aids! As an RN of 23 years who has suffered ADHD since childhood, I only decided to try medication therapy last year due to a fear of stimulants and the stigma (and potential addiction) they carry. After trying a few non-stimulants without success, I begun 10 then 20 mg of Adderall BID with great results..... but side effects. (dry mouth is the worst) Never being one to give up, however, I did more research on off-label non-stimulant medication and was delighted to discover the antihypertensive medication (Tenex/Guanfacine) which has not only been an extremely effective adjunct to my Adderal but replaced the bp meds I was currently taking. I've been taking Tenex 2 mg BID for several months now and the results have been miraculous! Other than sleepiness during the first few weeks, I've had no other side-effects. Being inquisitive as I am, however, I wanted to know the mechanism of action that Guanfacine has but found most medical articles a bit confusing so when I stumbled upon this Rapid-Review I was very impressed! It was extremely informative, explained in layman's terms and really helped me understand the why and how neurotransmitter deficiencies/imbalances can surely explain the symptoms of ADHD. ....... To recall all the trips to the principal's office, the hours I spent in after school detention, and sadly, the many beatings I endured for being a "bad kid" makes me feel kind of relieved that I really didn't "deserve" them. Thank You Again for the great Rapid Article! Joyfully Charlene~
Hi! This is actually my research. To clear up some confusion, guanfacine and clonidine MIMIC norepinephrine at post-synaptic receptors in the prefrontal cortex, and strengthen prefrontal connections. Hope that helps
I have a question. Did Gluanfacien decrease or increase noradrenaline? Because when I google it some study say yes and other no. The last doctor I see told me yes and the other one I see told me no. So I’m really confused… 😅 Thank you!
Hold up, if alpha 2 agonists inhibit acetylcholine release, can alpha 2 blockade by antipsychotics in turn somewhat mitigate their antimuscarinic effects?
To some extent, alpha 2 blockade increases acetylcholine release, but there's the direct blockade of the muscarinic acetylcholine receptors which can't be overcome. Most of the acetylcholine would end up acting at the nicotinic acetylcholine receptors because of alpha 2 blockade. The main thing with alpha 2 blockade by anti-psychotics is that it helps to mitigate the anti-dopamine action by dis-inhibiting nor-epinephrine, serotonin, and dopamine release (throughout the brain and especially in the prefrontal cortex) which reduces the risk of EPS symptoms.
@@Destroyer9747 I don't know how this is possible, but a month after starting 600 mg Quetiapine, I found that it actually made me struggle to fall asleep, as if there was static noise in my brain. It also somehow made my heart rate tank by 10-15 beats per minute, you'd expect the opposite from an anticholinergic. And the most shocking is that out of a sudden, I'd get these memories from like years ago flashing back to me. How can an antimuscarinic cause this? Is it because of NET blockade or Alpha 2 Blockade?
@@maestro9765 Look man, I'm no medical professional, so this isn't medical advice. I'm just some pharmacology nerd/researcher on the internet, and what your describing is something that you should bring up with your prescribing doctor (assuming they listen). If you're already trying to follow the advice of random strangers on the internet, then you probably need a new doctor (if they won't listen). That said, Quetiapine is a "low-potency atypical anti-psychotic" that isn't selective for any specific pathway (kind of like carpet bombing your brain to make your issues "manageable" by blocking dopamine, serotonin, adrenaline, muscarinic receptors) that would result in your "side-effects", but the anti-histamine/anti-cholinergic effects will stop helping you sleep once you've gotten acclimated to the drug. It also sounds like you might have other issues (PTSD?) which may need to be addressed in therapy and other wellness practices. Drugs by themselves won't make you feel better without action on your part, so I suggest mild exercise as a "drug-booster" and as a sleep aid. Your prescribing doctor will figure out if you need additional substances to counter-act your "side-effects", since they should've gone through med-school (which doesn't necessarily weed out all "bad doctors") to be able to prescribe.
Can this work effectively with Vyvanse to moderate stimulative side effects like increased heart rate and blood pressure. I’m currently on 50 mg of Vyvanse but have developed high blood pressure and increased heart rate when standing. I wanted to discuss with my doctor if taking this with a lower dose of Vyvanse might control the blood pressure and eliminate the increased heart rate problems. I was on Vyvanse for about 7-8 years.
Came here for sort of the same thing. Just started 30mg Vyvanse, but I'm now struggling with no diet, no sleep, increased anxiety and restlesses (I feel more hyper/over-stimulated on Vyvanse) - I heard clonidine can have similar effects to benzo, without the risk of addiction.
According to Dr Russell Barkley, people are now combining stimulant and nonstimulant medications at lower doses for a more widespread positive effect with less negative side effects. I take vyvanse too and came across this video after watching his video on the different types of ADHD medication and how they work. I plan on speaking to my psychiatrst about it. I encourage you to speak to one too as only they will be able to give you the best and safest advice
@@matthewoconnor3376 Thank you Matthew. Since posting this my regimen has completely changed. I was diagnosed with POTS last month. I’m taking 50-100mg Modafinil in lieu of 50mg of Vyvanse. I was put on a baby dose of lisinopril and a micro dose of metoprolol to control the inconsistent BP and high heart rate when standing. To be honest the Vyvanse causes more agitation and I’ve gotten the same results with modafinil. I was prescribed 10mg of Vyvanse in case I wanted to combine it with the modafinil but it also seems to cause increased heart rate more frequently than modafinil and I’m finding it’s not needed. I now take several nootropic supplements which improve energy, mental focus, memory, concentration and help alleviate brain fog in general. I’m beginning to wonder if I actually have ADHD and if hasn’t been POTS all along since the memory, focus and concentration problems are what prompted the doctor to diagnose me with ADHD and they’re major POTS symptoms. I also suffer from severe insomnia and fatigue also major POTS symptoms. They thought the fatigue was related to lack of sleep, but looks like both are POTS related. It’s quite possible I have ADHD and POTS as it’s been found that many POTS sufferers were diagnosed with ADHD. FYI, Doctors advised that the non-stimulate ADHD meds are actually harder on your heart. Kinda crazy but they can impact the nervous system which might be problematic for POTS. Take care. ✌🏽♥️🙏🏽
Yes, guanfacine can be added onto stimulants. It was actually tested and approved as both a monotherapy and in combination with ADHD stimulant medications.
My doctor has no idea what she's doing. I'm on benzos plus Naprosyn right now for pain and this medication isn't to be mixed with benzos or that. I took one the other day before bed and wish to God I never did. I woke up at 2am something this morning eastern time and Its making me feel sick. Definitely tossing it straight in the garbage can
I'm sorry that happened to you! I just wanted to say that it's very important to dispose of medications responsibly, please take unused medications to your local pharmacy for safe disposal
This is exactly what I was looking for! I just couldn't see how/why a2A receptor agonism could yield both in increase and a decrease in norepinephrine; the fact that there are more postsynaptic than presynaptic a2A receptors the PFC makes sense! Thanks!
Wow, THANK YOU SO MUCH for the great article and visual aids!
As an RN of 23 years who has suffered ADHD since childhood, I only decided to try medication therapy last year due to a fear of stimulants and the stigma (and potential addiction) they carry. After trying a few non-stimulants without success, I begun 10 then 20 mg of Adderall BID with great results..... but side effects. (dry mouth is the worst) Never being one to give up, however, I did more research on off-label non-stimulant medication and was delighted to discover the antihypertensive medication (Tenex/Guanfacine) which has not only been an extremely effective adjunct to my Adderal but replaced the bp meds I was currently taking. I've been taking Tenex 2 mg BID for several months now and the results have been miraculous! Other than sleepiness during the first few weeks, I've had no other side-effects.
Being inquisitive as I am, however, I wanted to know the mechanism of action that Guanfacine has but found most medical articles a bit confusing so when I stumbled upon this Rapid-Review I was very impressed! It was extremely informative, explained in layman's terms and really helped me understand the why and how neurotransmitter deficiencies/imbalances can surely explain the symptoms of ADHD. ....... To recall all the trips to the principal's office, the hours I spent in after school detention, and sadly, the many beatings I endured for being a "bad kid" makes me feel kind of relieved that I really didn't "deserve" them. Thank You Again for the great Rapid Article!
Joyfully Charlene~
These videos are so damn good. Please keep them coming!
Thank you!
Hi! This is actually my research. To clear up some confusion, guanfacine and clonidine MIMIC norepinephrine at post-synaptic receptors in the prefrontal cortex, and strengthen prefrontal connections. Hope that helps
I have a question. Did Gluanfacien decrease or increase noradrenaline? Because when I google it some study say yes and other no. The last doctor I see told me yes and the other one I see told me no. So I’m really confused… 😅
Thank you!
They decrease noradrenaline release, but mimic its actions at alpha-2A receptors @@ubded9597
Does guanfacine affect dopamine in anyways?
Hey, put patreon link in description, I want to support you
More rapid reviews like this please!
This was very well described. Thank you.
Yeah that was very helpful
Great video!
Thanks!
guanfacine has done wonders for me
How did help?😊
Hold up, if alpha 2 agonists inhibit acetylcholine release, can alpha 2 blockade by antipsychotics in turn somewhat mitigate their antimuscarinic effects?
To some extent, alpha 2 blockade increases acetylcholine release, but there's the direct blockade of the muscarinic acetylcholine receptors which can't be overcome. Most of the acetylcholine would end up acting at the nicotinic acetylcholine receptors because of alpha 2 blockade. The main thing with alpha 2 blockade by anti-psychotics is that it helps to mitigate the anti-dopamine action by dis-inhibiting nor-epinephrine, serotonin, and dopamine release (throughout the brain and especially in the prefrontal cortex) which reduces the risk of EPS symptoms.
@@Destroyer9747 I don't know how this is possible, but a month after starting 600 mg Quetiapine, I found that it actually made me struggle to fall asleep, as if there was static noise in my brain. It also somehow made my heart rate tank by 10-15 beats per minute, you'd expect the opposite from an anticholinergic. And the most shocking is that out of a sudden, I'd get these memories from like years ago flashing back to me. How can an antimuscarinic cause this? Is it because of NET blockade or Alpha 2 Blockade?
@@maestro9765 Look man, I'm no medical professional, so this isn't medical advice. I'm just some pharmacology nerd/researcher on the internet, and what your describing is something that you should bring up with your prescribing doctor (assuming they listen). If you're already trying to follow the advice of random strangers on the internet, then you probably need a new doctor (if they won't listen). That said, Quetiapine is a "low-potency atypical anti-psychotic" that isn't selective for any specific pathway (kind of like carpet bombing your brain to make your issues "manageable" by blocking dopamine, serotonin, adrenaline, muscarinic receptors) that would result in your "side-effects", but the anti-histamine/anti-cholinergic effects will stop helping you sleep once you've gotten acclimated to the drug. It also sounds like you might have other issues (PTSD?) which may need to be addressed in therapy and other wellness practices. Drugs by themselves won't make you feel better without action on your part, so I suggest mild exercise as a "drug-booster" and as a sleep aid. Your prescribing doctor will figure out if you need additional substances to counter-act your "side-effects", since they should've gone through med-school (which doesn't necessarily weed out all "bad doctors") to be able to prescribe.
Is alpha 2 agonist the same as alpha adrenergic agonist?
I looked at the picture
Thanks!! 💖
Can this work effectively with Vyvanse to moderate stimulative side effects like increased heart rate and blood pressure. I’m currently on 50 mg of Vyvanse but have developed high blood pressure and increased heart rate when standing. I wanted to discuss with my doctor if taking this with a lower dose of Vyvanse might control the blood pressure and eliminate the increased heart rate problems. I was on Vyvanse for about 7-8 years.
Came here for sort of the same thing. Just started 30mg Vyvanse, but I'm now struggling with no diet, no sleep, increased anxiety and restlesses (I feel more hyper/over-stimulated on Vyvanse) - I heard clonidine can have similar effects to benzo, without the risk of addiction.
According to Dr Russell Barkley, people are now combining stimulant and nonstimulant medications at lower doses for a more widespread positive effect with less negative side effects. I take vyvanse too and came across this video after watching his video on the different types of ADHD medication and how they work. I plan on speaking to my psychiatrst about it. I encourage you to speak to one too as only they will be able to give you the best and safest advice
@@matthewoconnor3376 Thank you Matthew. Since posting this my regimen has completely changed. I was diagnosed with POTS last month. I’m taking 50-100mg Modafinil in lieu of 50mg of Vyvanse. I was put on a baby dose of lisinopril and a micro dose of metoprolol to control the inconsistent BP and high heart rate when standing. To be honest the Vyvanse causes more agitation and I’ve gotten the same results with modafinil. I was prescribed 10mg of Vyvanse in case I wanted to combine it with the modafinil but it also seems to cause increased heart rate more frequently than modafinil and I’m finding it’s not needed. I now take several nootropic supplements which improve energy, mental focus, memory, concentration and help alleviate brain fog in general. I’m beginning to wonder if I actually have ADHD and if hasn’t been POTS all along since the memory, focus and concentration problems are what prompted the doctor to diagnose me with ADHD and they’re major POTS symptoms. I also suffer from severe insomnia and fatigue also major POTS symptoms. They thought the fatigue was related to lack of sleep, but looks like both are POTS related. It’s quite possible I have ADHD and POTS as it’s been found that many POTS sufferers were diagnosed with ADHD. FYI, Doctors advised that the non-stimulate ADHD meds are actually harder on your heart. Kinda crazy but they can impact the nervous system which might be problematic for POTS. Take care. ✌🏽♥️🙏🏽
@@matthewoconnor3376 Mine refused to do this, but I think sometimes they're not always up on the most recent literature.
Yes, guanfacine can be added onto stimulants. It was actually tested and approved as both a monotherapy and in combination with ADHD stimulant medications.
My doctor has no idea what she's doing. I'm on benzos plus Naprosyn right now for pain and this medication isn't to be mixed with benzos or that. I took one the other day before bed and wish to God I never did. I woke up at 2am something this morning eastern time and Its making me feel sick. Definitely tossing it straight in the garbage can
I'm sorry that happened to you! I just wanted to say that it's very important to dispose of medications responsibly, please take unused medications to your local pharmacy for safe disposal
Pardon me for asking, but did you throw away Guanfacine or did you mean that you threw away the benzos and or the Naprosyn?