How the Non-Stimulant Treatment Intuniv Can Help Children With ADHD

Intuniv is a non-stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). It is a long-acting form of guanfacine, which had previously been used to treat high blood pressure.

The medication was approved by the Food and Drug Administration (FDA) in September 2009. It was initially approved as a once-a-day treatment for children and adolescents 6 to 17 years old who have ADHD. Guanfacine had already been used off-label to treat children with ADHD who also have tics, sleep problems, or aggression.

In 2011, Intuniv received a new indication for use as adjunctive therapy for ADHD. This meant that it could be used with a stimulant ADHD medicine such as Concerta, Focalin, Adderall XR, or Vyvanse, etc. It may also be used alone (monotherapy) to treat ADHD.

Intuniv for ADHD

Important factors to consider about taking Intuniv include:

• The pill must be swallowed whole. Intuniv is a pill, but unlike some other ADHD medications, like Qelbree, it cannot be crushed, chewed, or broken.
• It's not a controlled substance. Like Strattera and Kapvay, other non-stimulants for ADHD, Intuniv is not a controlled substance, which can make getting refills easier for parents.
• It does not cause much appetite suppression. Unlike other ADHD medications—especially stimulants like Adderall, Concerta, or Vyvanse—a benefit of Intuniv is that it does not cause much appetite suppression. This can make it a good choice for children who have problems gaining weight when taking a stimulant.

Dosage

Intuniv is available in four dosage strengths:

• 1 milligram
• 2 milligrams
• 3 milligrams
• 4 milligrams

Most children will start Intuniv at the 1 milligram dosage and then increase by 1 milligram each week until they get to a target dose of 3 milligrams or 4 milligrams.

In 2014, the FDA allowed more weight-based, flexible pediatric dosing, with maximum doses up to 7 milligrams for older teens. Weight-based target doses range from 0.05 to 0.12 milligram/kilogram/day.

Side Effects

Side effects of Intuniv most commonly include:

• Somnolence (which can occur in up to 38% of patients)
• Headaches
• Fatigue
• Upper abdominal pain
• Nausea
• Lethargy
• Dizziness
• Irritability
• Decreased blood pressure
• Decreased appetite

Although somnolence occurs in a large number of children when they start taking Intuniv, it seems to get better as they continue to take it. For some children this is a benefit as it helps them fall asleep if they are given their dose at bedtime. (Intuniv can either be given in the morning or the evening.)

Warnings

Warnings about Intuniv include:

• It should be used cautiously if your child is at risk for certain health conditions. These include low blood pressure, bradycardia (low heart rate), heart block, or syncope (fainting).
• It should be used cautiously if your child is also taking certain medications. These include ketoconazole, rifampin, valproic acid, antihypertensive drugs, or CNS depressants (sedatives, antipsychotics, etc.).
• It should not be taken with a high-fat meal. It can be taken with water, milk, or other liquids.
• It should not be stopped suddenly. Instead, the medication should be discontinued slowly, by decreasing or tapering the dose over several weeks.

Should Your Child With ADHD Try Intuniv?

Intuniv may be an especially good option if your child's current medication simply isn't working well, they haven't been able to tolerate other stimulants because of side effects, or if you have been wary of putting them on a stimulant.

As with Tenex, immediate-release guanfacine, Intuniv may be used to treat children with ADHD and tics, sleep problems, or aggression, either by itself or with a stimulant.