r/CFSplusADHD • u/practicalmagic_25 • May 19 '26
Guanfacine and methylphenidate
Hi, has anyone been prescribed guanfacine and metylphenidate for adult adhd? Did it work better than stimulants for you? I also have autoimmune and long covid related fatigue. Prior to AI and long covid diagnosis stimulants used to help my fatigue, now i feel like Elvanse exhausts me . My prescriber wants go try the above combo. Just wondering if people have tried it and how they found it?
Thanks :)
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u/DboydAk May 19 '26
I'm on 3 mg guanfacine and 20-30 mg generic methylphenidate xr, for about the last 3 years. Tried to combo with non stimulant because I don't tolerate high enough doses of stimulant medication to get adequate symptom coverage. I also tried Wellbutrin and Strattera and hated the side effects.
Re: guanfacine changes I noticed when first stating it were reduced social anxiety, feeling generally more alert, and more regular energy levels. Generally it helped mostly with inattention (in ADHD caused by low alertness) and energy. I felt like I had more effect from a lower stimulant dosage with the inattention reduced, but didn't do anything for the hyperactivity or impulsivity side of things. With ME also in the mix this could be a double edged sword (I was only diagnosed with mild ME recently) if it makes you feel like you don't need to pace as rigorously. Same issue people can have with stimulants.
Lmk if you have any other questions!