Are Adderall and guanfacine the same thing? Understanding the Key Differences

October 8, 2025 •

4 min read

While both Adderall and guanfacine are prescribed to treat Attention-Deficit/Hyperactivity Disorder (ADHD), they belong to entirely different classes of medication and have distinct mechanisms of action. In fact, the answer to are Adderall and guanfacine the same thing? is a definitive no, as one is a stimulant and the other is a non-stimulant.

Quick Summary

Adderall is a stimulant used for ADHD and narcolepsy, increasing dopamine and norepinephrine levels. Guanfacine is a non-stimulant for ADHD and high blood pressure, working as a centrally-acting alpha agonist with a calming effect. They differ significantly in drug class, mechanism, side effects, and controlled substance status.

Key Points

Drug Class Difference: Adderall is a CNS stimulant, whereas guanfacine is a non-stimulant alpha-2A adrenergic receptor agonist.
Mechanism of Action: Adderall increases stimulant neurotransmitters like dopamine and norepinephrine, while guanfacine has a calming effect by stimulating specific receptors.
Controlled Substance Status: Adderall is a Schedule II controlled substance with a high potential for abuse, unlike guanfacine, which is not controlled.
Side Effect Profiles: Adderall is associated with insomnia and appetite loss, while guanfacine commonly causes drowsiness and dizziness.
Approved Uses: Both treat ADHD, but Adderall also treats narcolepsy, and guanfacine's immediate-release form can treat high blood pressure.
Therapeutic Timeline: Adderall has a rapid onset, while guanfacine's full effects are seen over a longer period.

What is Adderall?

Adderall is a brand-name prescription medication containing a combination of amphetamine and dextroamphetamine, which are central nervous system (CNS) stimulants. It is a controlled substance due to its high potential for abuse and dependency. These active ingredients work by increasing the levels of certain neurotransmitters—primarily dopamine and norepinephrine—in the brain. By doing so, Adderall helps to improve concentration, focus, and alertness in individuals with ADHD, while also being effective for treating narcolepsy.

Common uses for Adderall include:

Attention-Deficit/Hyperactivity Disorder (ADHD): Used to reduce symptoms of inattention, hyperactivity, and impulsivity in both children (age 3+) and adults.
Narcolepsy: Prescribed to help manage excessive daytime sleepiness.

What is Guanfacine?

Guanfacine, available in both immediate-release (Tenex) and extended-release (Intuniv) formulations, is a non-stimulant medication. Its extended-release form is specifically approved for the treatment of ADHD, while the immediate-release version is primarily used for high blood pressure. Guanfacine is classified as a centrally-acting alpha-2A adrenergic receptor agonist. Instead of increasing overall stimulant activity like Adderall, it is thought to strengthen working memory, reduce distractibility, and improve impulse control by affecting receptors in the prefrontal cortex. This mechanism results in a more calming effect on the brain compared to stimulants.

Common uses for Guanfacine include:

Attention-Deficit/Hyperactivity Disorder (ADHD): The extended-release form (Intuniv) is used in children and adolescents, sometimes alone or in combination with stimulants.
High Blood Pressure (Hypertension): The immediate-release version (Tenex) is used to lower blood pressure by relaxing blood vessels.

Comparing the Medications: A Detailed Overview


Feature	Adderall	Guanfacine
Drug Class	Central Nervous System (CNS) Stimulant	Centrally-Acting Alpha-2A Adrenergic Receptor Agonist (Non-stimulant)
Mechanism of Action	Increases dopamine and norepinephrine levels in the brain.	Stimulates alpha-2A adrenergic receptors to improve executive function and reduce impulsivity, with a calming effect.
Controlled Substance?	Yes, Schedule II. High potential for misuse and dependency.	No. Lower potential for misuse.
Common Side Effects	Insomnia, loss of appetite, stomach pain, increased heart rate and blood pressure, headaches.	Drowsiness, fatigue, dry mouth, dizziness, nausea, low blood pressure.
Onset of Action	Rapid onset of action.	Slower onset of action; can take several weeks for full therapeutic effects to be observed.
Therapeutic Uses	ADHD, Narcolepsy.	ADHD (extended-release), Hypertension (immediate-release).
Use in Children	FDA-approved for children age 3 and older for ADHD.	FDA-approved for children and adolescents ages 6-17 for ADHD.

Potential Side Effects and Risks

The side effect profiles for Adderall and guanfacine are vastly different due to their opposing mechanisms. Adderall's stimulant nature means users are more likely to experience agitation, insomnia, and appetite suppression. While these side effects often lessen over time, Adderall also carries risks of increased heart rate and blood pressure, as well as a significant potential for abuse.

Guanfacine, by contrast, often causes sleepiness and drowsiness, especially when first starting the medication. Other common side effects include dry mouth, dizziness, and low blood pressure. These sedative effects can be beneficial for individuals with both ADHD and co-occurring anxiety or sleep problems, but they can also be a significant limitation for those who need to maintain alertness throughout the day.

Who is each medication for?

Choosing between Adderall and guanfacine is a decision that a healthcare provider makes based on an individual's specific needs, symptoms, and medical history. Factors to consider include:

Symptom Profile: Some individuals respond better to stimulants for focus and attention, while others with significant hyperactivity or aggression may benefit more from the calming effects of a non-stimulant like guanfacine.
Comorbid Conditions: For patients with existing anxiety, tic disorders, or sleep issues, a non-stimulant like guanfacine may be preferred over a stimulant that could exacerbate these problems. Conversely, for patients with narcolepsy in addition to ADHD, Adderall is the more appropriate choice as guanfacine is not indicated for this condition.
Risk of Abuse: Due to its potential for misuse, Adderall may not be suitable for individuals with a history of substance abuse. Guanfacine offers a lower-risk alternative in such cases.
Side Effect Tolerance: A patient's tolerance for side effects is also a factor. If insomnia or appetite loss is a major concern, guanfacine might be a better option, while for those bothered by sedation, Adderall would be more suitable.

Conclusion

In summary, the key takeaway is that Adderall and guanfacine are not the same thing; they are distinct pharmacological agents used to treat different aspects of ADHD and other conditions. Adderall is a potent stimulant that increases neurotransmitter activity for increased focus, while guanfacine is a non-stimulant that calms the central nervous system to improve impulse control and attention. The choice between them depends on a careful evaluation of the patient's symptoms, health, and treatment goals by a qualified medical professional. There is no one-size-fits-all solution, and some individuals may even be prescribed a combination of medications for optimal results. It is crucial to have a detailed discussion with a doctor to determine the most effective and safest treatment plan.

For more information on the distinctions, review the resources available on MedlinePlus.

Frequently Asked Questions

Yes, in some cases, a healthcare provider may prescribe a combination of Adderall and guanfacine, particularly if a patient's ADHD symptoms are not fully managed by a single medication. Guanfacine can help address certain symptoms like hyperactivity or aggression that stimulants may not resolve.

There is no single answer, as the effectiveness of either medication depends on the individual's specific symptom profile, medical history, and response to treatment. Stimulants like Adderall are often a first-line treatment, but non-stimulants like guanfacine are a vital alternative for those who cannot tolerate or do not respond well to stimulants.

No, guanfacine does not have the same potential for abuse. Adderall is a Schedule II controlled substance with a high risk of dependency and misuse, whereas guanfacine is a non-controlled substance with a much lower risk.

Adderall commonly causes agitation, insomnia, and loss of appetite due to its stimulating effects. In contrast, guanfacine is more likely to cause drowsiness, dizziness, and fatigue because of its calming effect on the central nervous system.

A doctor might choose guanfacine over Adderall for several reasons, including a patient's sensitivity to stimulants, presence of comorbid conditions like anxiety or tic disorders, concerns about potential for abuse, or if the patient's symptoms respond better to a non-stimulant approach.

Guanfacine (Intuniv) is FDA-approved for ADHD in children and adolescents ages 6-17. While its use in adults is not officially approved for ADHD, a doctor may sometimes prescribe it off-label after careful consideration of the patient's needs.

No, Adderall has a much faster onset of action due to its stimulant properties. The therapeutic effects of guanfacine, being a non-stimulant, take longer to build up in the system and may require several weeks for full benefit.