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Intuniv vs generic guanfacine for ADHD

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Intuniv is a long acting version of guanfacine being promoted for ADHD in children. Guanfacine, or Tenex, has been used off-label for years for ADHD and seems to have some benefit. I can't figure out why guanfacine, a generic drug with a half life of about 17 hours, available at Walmart for $4, needs to be replaced by an expensive brand. Neither is as effective as stimulants, but there are occasions, such as comorbid substance abuse or bipolar disorder that make stimulants problematic. Which do you prescribe? Please give me your rationale below.

(By the way, NEVER write "TENEX" on a script unless you are doing electronic prescribing. Too easy to mistake for or change to XANAX.)

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intuniv, tenex, guanfacine, stimulants, substance abuse, adhd, bipolar

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Which do you usually prescribe, Intuniv or generic guanfacine?

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