Tenex vs. Topamax

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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Qudexy Xr

Treats ADHD and lowers blood pressure. Tenex (Guanfacine) can be used to treat both blood pressure and ADHD, but it's not recommended as a first-line treatment for either problem.Prevents seizures and migraine headaches. Qudexy Xr (Topiramate) is useful for preventing seizures and migraines, and doesn't require blood tests while you're on it.
How it works
Tenex (Guanfacine) is a centrally-acting alpha agonist medication. It lowers blood pressure by slowing down the heart rate and relaxing the blood vessels. It's not clear how Tenex (Guanfacine) works in ADHD, but it's used when stimulants haven't worked or can't be used in people.Qudexy Xr (Topiramate) is an antiepileptic. Researchers don't know exactly how it works, but it seems to affect multiple parts of the brain to control seizures and migraines.
Type of medication
Alpha agonist
Prescription only
AnticonvulsantPrescription only
Available as
  • Pill
  • Extended release
  • Pill
  • Extended release capsule
Used for (click to learn more)
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
Reviews for Qudexy Xr (Topiramate)
-21% vs. Tenex (Guanfacine)
+2% vs. Tenex (Guanfacine)
-33% vs. Tenex (Guanfacine)
Side effects
  • Drowsiness 31%
  • Fatigue 8%
  • Dizziness 7%
  • Headache 5%
More Tenex side effects »
  • Tingling sensation 45%
  • Slowed-down thinking and movements 19%
  • Dizziness 17%
  • Drowsiness 17%
  • Fatigue 17%
  • Change in taste 14%
  • Difficulty with concentration/attention 13%
  • Nervousness 12%
  • Difficulty with memory 11%
  • Vision abnormal 11%
More Topamax side effects »
Risk factors for serious side effects
  • Taking other medications that cause sedation or sleepiness
  • Stopping Tenex (Guanfacine) suddenly to treat high blood pressure
Detailed Tenex (Guanfacine) risks & warnings »
  • History of depression
    • Children
    • History of metabolic disorders
    • People also taking Depakote
    • Low-carb diet
    • Dehydration
    • Drug interactions
      • Stopping Qudexy Xr (Topiramate) suddenly
      Detailed Qudexy Xr (Topiramate) risks & warnings »
      Pregnancy category
      BFDA pregnancy category (Probably safe)

      Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

      See the FDA package insert
      DFDA pregnancy category (Weigh risks vs. benefits)

      Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      See the FDA package insert
      • Limit the amount of alcohol you drink while taking this.
      No specific alcohol-related info.
      No specific food-related info.No specific food-related info.
      Kidneys and liver
      No specific kidneys and liver-related info.
      • A few people will get kidney stones.
      • Qudexy Xr (Topiramate) may increase your risk for kidney stones. Stay well-hydrated to lower your risk.
      No specific sex-related info.No specific sex-related info.
      No specific sleep-related info.No specific sleep-related info.
      No specific weight-related info.
      • Can cause sleepiness, speech problems, tingling sensations, and weight loss.
      Upsides and benefits
      • The same medication treats two different things, high blood pressure and attention deficit hyperactivity disorder (ADHD).
      • It's not a "controlled medication".
      • Used to control ADHD when stimulant medications haven't worked or can't be used due to other medical problems.
      • Available as a generic medication, so it should be more affordable than other options.
      • Used on its own or with other antiepileptic medicines to lower the frequency of seizures, especially for people with tonic-clonic or partial seizures, or Lennox-Gestaut syndrome.
      • Helpful in preventing frequent migraine headaches.
      • Doesn't need routine blood tests.
      Downsides and risks
      • Doesn't control ADHD as well as stimulants do, so it's used as a second-line medication.
      • Not a preferred drug to control blood pressure.
      • Can't be stopped suddenly, especially for blood pressure, since the blood pressure can dramatically increase.
      • Can cause sleepiness, speech problems, tingling sensations, and weight loss.
      • A few people will get kidney stones.
      • Not safe to use if you're pregnant.
      Tips from our pharmacists for people taking the medication
      • Don't stop taking Tenex (Guanfacine) without talking to your doctor first.
      • Limit the amount of alcohol you drink while taking this.
      • Drink plenty of liquids and don't get overheated while taking Tenex (Guanfacine).
      • You can feel sleepy the first few times you take it, or when your dose is increased. Don't drive or do anything that requires concentration until you know how the medication affects your body.
      • Can take up to 2 weeks for the maximum effect.
      • For the first week, avoid activities that require you to be alert.
      • Don't use if pregnant.
      • Can cause tingling skin sensations and reduced appetite.
      • Report any confusion, decreased sweating, fever, or changes in behavior or vision.
      • Takes 3 to 4 weeks to feel full effects on mood.
      Learn more
      More about TenexSide effectsReviews & ratingsAlternativesFDA package insert
      More about TopamaxSide effectsReviews & ratingsAlternativesFDA package insert