petrichor: Looking for info about coming off Intuniv (extended release guanfacine)

[petrichor]

Hello! I've had a hard time finding information about getting off of Intuniv, since I think it's a less common psych med. My psychiatric provider has said she has no concerns about me stopping it cold turkey any time I want to, since I'm only on 1 mg, but if I'm "really nervous about it" she would recommend taking it every other day for a while  - but I have reason to be a little suspicious of that recommendation, right? 

From what I've read, the main withdrawal risk is high blood pressure... I already have a history of tachycardia and prehypertension, which my provider is well aware of. 

Since Intuniv is extended release, my understanding is the tablets should never be cut in any way. Is switching to immediate release guanfacine something that I should consider, in order to be able to taper? 

I'd be so appreciative of any info you might have - withdrawal risks I should be aware of, information about tapering this drug, how to talk to my provider, how to prepare for possible withdrawal, or anything else! 

Happy to answer any questions you might have! Also please let me know if I have the right level of info in my signature. In terms of non-psych meds, I take Flonase during allergy seasons, and if I get a cold I might take Sudafed and ibuprofen (though I've been nervous about interactions with Intuniv), and I used to be on birth control pills, but stopped them in December 2021. And I carry an EpiPen and Benadryl in case of an allergic reaction to peanuts (the EpiPen is why I stopped propranolol, I found out it can prevent an EpiPen from working 😳). Let me know if any of that should be added to my signature!

[petrichor]

No worries if you don't have any info about Intuniv! I know that ADs are the main focus here, I just thought it was worth asking since sometimes other types of meds are discussed here. By searching the site I had seen Intuniv has come up a few times, but not in much detail. I totally understand if you can't help!

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

Are you able to obtain a liquid prescription for the drug from your provider? Tapering by 10% of your current dose each month would be our recommendation, and it wouldn't take too long to reach 0 from 1mg. Your taper would be something like: 1mg --> 0.9mg --> 0.81mg --> 0.73mg --> 0.66mg etc.

 

If a liquid is not available switching to the immediate release compound, like you suggested, is your next best bet. Is 1mg the smallest tablet size the XR version comes in?

[petrichor]

Thanks so much for the welcome and the suggestion @Erimus! When I search Google for "Intuniv liquid" and "guanfacine ER liquid," the only results I'm finding are for compounding pharmacies offering liquid guanfacine IR (immediate release). So if it's true that it's not possible to get the extended release in liquid form, I imagine it wouldn't matter whether I choose immediate release liquid or immediate release tablets? 

 

Do you (or anyone else reading) have any tips for broaching this topic with my provider and explaining why I'm hesitant to try her recommendations of cold turkey or skipping doses? She likes to remind me that this drug is "safe enough for kids" and also made a random aside once advising me not to go to places like Reddit to read scary stories about psych meds... Other than that she has seemed nice and claims that she believes in giving patients agency in their treatment.