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  #16  
Old 10-10-06, 05:41 PM
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Glad to see you again unleashed...I hadn't seen you post in a while. I missed your thoughtful posts.
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Yes, SCT is not listed in the DSM4 which was published in 1994. The next edition is planned for 2011. Is it important that we not talk about these kids until this category is possibly listed in 2011 or beyond?

I don't think the diagnostic labeling is the major issue. For instance, Andrew's mom doesn't really care what her child is labeled with as long as he gets the best service and treatment possible.

What is important, is providing best practices for these children. At school where I work these kids, this group is a clear and distinct from other ADHDers. Do I write SCT on these kids IEP's? No, but I know that generally, these "foggy" kids have a unique set of problems not related to classic ADHD. Typically they have true processing difficulties and memory retrieval difficulties. I see this everyday. Am I simply to ignore this and not provide special accommodations for these kids because these issues are not typically an ADHD problem? That would be a little backwards.

My philosophy is to provide the best service possible based on current info and best practices suggested by current research. Slap my wrists if you must but what matters is to do the best job possible.
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  #17  
Old 10-12-06, 09:55 AM
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I have no issue with doing the best job possible. I'm just concerned about confusing labels.

I came here newly diagnoses as ADHD-pi, I started reading SCT posts. So I thought I was SCT. The dose of my medication wasn't right at first, and I was reading how the meds aren't always effective against SCT. So I started to get discouraged because I thought I'd finally be able to deal with my problem, and here I was reading information saying I didn't have what I thought I had, and since the meds weren't working well, I was problably out of luck.

Then I read what Barkley actually wrote, his idea of 'combined type' was different than the DSM definition. If you had any impulsive/hyperactive symptoms at all, Barkley would consider you combined, whereas you need 6 under the DSM. So then I realized I was ADHD after all, not SCT. After that I regained hope and started making progress with the meds.

So that's the reason I'm picky about posts that suggest that ADHD-pi is a separate disorder, because it's not so cut and dried.
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Old 10-12-06, 04:09 PM
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Quote:
Originally Posted by UnleashTheHound
....because it's not so cut and dried.
Nope...it's tricky and complicated. Do not attempt to do this at home.

Then again, if you go to a Doctor, they may have no idea what you are talking about anyways. I wish I could say that you just need to find a professional who has expertise in this area, but that is not always possible.
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Old 08-02-07, 09:18 PM
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Treatment framework for adults with SCT?

<p>Just came across the info on Sluggish Cognitive Tempo this week, and am quite sure if I could find a time machine and drag my 7 year old self in to see Dr. Barkley he'd be using that child of many years ago as his poster boy.</p>
<p>However, as I am now an adult, without access to such time machine, and more than a little frustrated with the lack of info on what works for Adults with ADHD, I am wondering if any one here has any links to effective strategies, tactics, compensations, approaches or treatments, other than medication, specific to Adults with SCT. Nothing against meds, I'm on a stimulant and it helps, but not enough for me to be functional and stable. </p>
<p>Am looking through the other topics on treatment, but every thing I've found so far has been very generalized, or honestly reads more like a sales pitch for a coach, rather than a treatment module. I'm trying to find a framework of what works and why. Thanks for any pointers or info any one may share.</p>
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Old 08-03-07, 02:20 PM
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Wow. Thank you for that post.
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Old 08-15-07, 10:30 PM
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To follow up to my own question on what treatment modules/strategies are helpful for those with ADD-SCT, a chance conversation brought me to look at the symptoms and problems those coming off crystal meth addiction often experience. While the symptoms are not fully congruent, there are enough parallels (easily bored, low energy, low motivation, difficulty concentrating, difficulty with multi-variable problem solving, increase in anxiety) to make me wonder if some of the treatment methodology used might be of benefit for those with this sub-form of ADHD/ADD. Does any one know if there is any research or information on Motivational Interviewing, Motivational Enhancement Therapy (MET), and/or Rewards/Contingency Management for treatment of ADHD/ADD? Anything specific on Problem Oriented Cognitive Behavorial Therapy? Again, I find very vague and general statements, but little in the way of "how to do it" or "why it works". Please post if you come across anything. Thanks.
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  #22  
Old 08-17-07, 03:45 AM
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Holy Crap!!! When I read the Wikipedia explination of SCT, it was a big relief. There may not be much known about it, but at least I have an explaination of why my brain isn't working as fast as I want it to.

I am going to the doctor tomarrow and see what he thinks about this.
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Old 08-27-07, 10:52 AM
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I've run out of meds waiting for my controlled substance to make its way through bureaucratic mess of state laws and insurance rules, and to reassure myself that I am really not a criminal for using amphetamine salts, decided to check up on the status of add/adhd in the public opinion. Came across SCT at Wikipedia, and now my whole life makes sense! I'd like to share my treatment experiences:

Adderall: Generic adderal is my treatment of choice. For me it takes care of the Slugishness and the lack of motivation. It does not help the working memory, or mixed up logic, but, but it motivates me to concentrate on whatever work I'm doing for long enough to work through the memory problems.

Strattera and Caffeine (I mean each individually, not together) take care of the sluggishness, but do nothing for motivation, and tend to leave me in a very uncomfortable restless state.

ajterreault: Methamphetamines being similar to the dextroamphetamines and amphetamines which make up adderall, I often feel I am no better than a meth addict, only I get my drugs legally. I have to believe that a good number of meth addicts have some sort of add or something like it only dont have the resources to diagnose is, thus self medicate with meth. In that case the those symptoms may have been there before the addict even started using meth.... i could be wrong.
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Old 08-27-07, 01:27 PM
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So when is "Sluggish Cognitive Tempo" going to have its own subforum on here? This is exactly me.

I have no motivation,sluggish and always tired. I am quite, introvert, shy and suffer from social anxiety. I am terrible with mathmatics once I get to multiplication.

Those symptoms are me 100%. That is the answer I have been trying to find for the past 24yrs.

I am the complete opposite of your normal ADHDer. I brought all the paperwork on this to my therapist today and he is going to send the recommendation to my family doctor to let me try adderall.
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  #25  
Old 08-27-07, 02:42 PM
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Hey guys! I started a topic about this awhile back in the Scientific forum:

http://www.addforums.com/forums/showthread.php?t=41839

The general consensus (as of now) seems to be that while SCT is probably an accurate sub-group, the treatment for it is pretty much = ADHD-PI (i.e. stimulants) so there's really no reason to split them apart.

I think the main thing reason why they need to be split is the hyperactivity symptom; generally ADHD is in the public mind as the disorder where you're hyper and can't sit still.

For those of us with SCT/ADHD-PI, it's hard to tell somebody that you have ADHD and they say "Wait...but you're not hyperactive? You're just making up excuses for your laziness."

I can't recall how many times I've heard that over and over and over. I think if SCT is made/labeled 'separate' it would be mainly to distinguish those of us with "ADD" instead of saying we have "ADHD". I think it was good for them to lump them all together initially when the disorder was still be discussed and researched - but now that it's pretty established I think they need to really delve into the different types of the disorder.

I mean, just like diabetes - they all have issues with insulin, but that doesn't mean you lump them together - the have type 1, type 2, etc. And for us it should be the same thing - we all have issues with attention defecit, but some of us are hyperactive (ADHD), some of us grow out it (Adult ADHD), and some us were never hyper to begin with (ADD/ADHD-PI/SCT).
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Old 08-27-07, 02:43 PM
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I hope the adderall works for you! If you search the Adderall board specifically, you will see that it helped a lot of people in the way you are looking for it to help you.

SCT seems to describe me fairly well also, but a lot of what it describes also goes along with some auto-immune disorders I have that cause severe fatigue and other things that then lead to the shyness, lack of motivation, et cetera. So it's complicated and I'm trying to figure out where I really fit.

As I said in your other post, though, the Adderall didn't help me with energy, and I am assuming it's becuase it's not only trying to work against the ADD but also the other causes of fatigue, and I just need something conjunction to create a one-two punch that might actually help.
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Old 08-27-07, 02:55 PM
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Quote:
Children with combined-type ADHD have many of the above symptoms, but they also have great difficulty sitting still (APA, 1994).
I am not "the complete opposite" of anybody with ADHD. The study isn't even suggesting "complete opposite", its suggesting "differences". I agree, there are differences, otherwise there would be no need to make any differentiations at all.

Quote:
-A significant percentage are not helped by methylphenidate.
Most respond positively to methylphenidate in moderate to high doses. Those who are helped by methylphenidate often do best at low doses. A significant subset are helped by amphetamines rather than methylphenidate.
I can take methylphenidate, or I can take the amphetamine class medication dexedrine...and ONLY dexedrine. I know plenty of combined and hyperactives who cannot take methylphenidates either, who also respond only to amphetamines of one type or another. This is definitely nothing that could be considered a cut-and-dried issue.

I tend to think that at the present time, the following type of thing also carries a lot of weight and bearing on the issue:

Quote:
Originally Posted by McTavish
It's not been substantiated as a "separate" disorder.

Therefore, ADHD-PI type remains as is.
Quote:
Originally Posted by McTavish
Research isn't personal; it's either valid & reliable over the long haul or it isn't.
Quote:
Originally Posted by McTavish
22 yrs of concentrated study,including the week I spent with Russ Barkley, have shaped my opinion.
Quote:
Originally Posted by McTavish
I'm a Licensed Psychologist in Minnesota with a Master's Degree...

Last edited by Andrew; 11-10-07 at 05:33 PM.. Reason: Edited for content
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Old 08-28-07, 12:45 AM
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Sluggish Cognitive Tempo (SCT) and Crystal Meth

Quote:
Originally Posted by gilly
Methamphetamines being similar to the dextroamphetamines and amphetamines which make up adderall, I often feel I am no better than a meth addict, only I get my drugs legally. I have to believe that a good number of meth addicts have some sort of add or something like it only dont have the resources to diagnose is, thus self medicate with meth. In that case the those symptoms may have been there before the addict even started using meth.... i could be wrong.
Gilly, from what I have read, long term crystal meth use has been associated with lesions and other physical damage to the brain, mostly in the frontal lobes, and sometimes permanent damage to the parts of the brain associated with the production of dopamine. As the frontal lobe and neurotransmitter issues are associated with ADHD/ADD, I am not surprised this would lead to similar symptoms, just as traumatic brain injury can. Indeed, I've found a few articles that indicate they are experimenting with using Adderall as part of treatment for this particular addiction, reinforcing the relationship. Whether or not some one had undiagnosed ADHD/ADD prior to the addiction really is irrelevant. What matters is simply - do these things cross-over and help us?

Frankly, I am at the point where I really don't care what causes ADHD/ADD, whether it be neurotransmitters, mis-wired frontal lobes, hemorrhoids, Chinese toothpaste, or special radio signals beamed by satellites launched by the New World Order (tongue-planted-firmly-in-cheek). All I really care about is what can I do about it. Pills help some, but they don't solve everything. Hence, my questions, what have people tried, and what has worked? What you and others have said about Adderall I found signifigant and helpful, and am looking forward to talking that drug over with my doctor very soon. Found some interesting articles today on Modafinil, which I want to look into further. The few blurbs I've found on Social Skills Training (SST) being helpful for those with ADD-SCT point toward another avenue, and I'll continue to look for anything else that might help, though I'll want several peer-reviewed double-blind studies as evidence showing aluminum foil head covers really work before adding that to my wardrobe.


Like many here, I am extremely frustrated with the problems that come with ADHD/ADD and how they have impacted on my life. I am even more frustrated with how little there is on what you can do about them. At least with message boards such as this, we can share what we know. Not much, but is something.
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  #29  
Old 09-15-07, 09:59 AM
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Well as someone who has ADHD-PI/SCT and has been on adderall for over a week. I can say I have noticed a slight difference in myself.

I am still on a low dosage as I tiltrate up, but here is what I have noticed so far.

Pros
- Eyes no longer feel heavy throughout the day.
- Increased motivation, although due to my low dosage, I start slacking by the time afternoon comes around.
- Increased Energy.
- A little more in the mood to talk to people. I think this has to do with the increased energy
- Social skills are still suffering. I still get bad anxiety. I am thinking I will probably have to do some Social Skills training to teach myself all the skills I failed to take in as I grew up.
- Increased Focus.
- I am finally waking up early in the mornings (7am-8am) with no problems at all, this is a big change coming from someone who used to sleep in atleast till 10:30 every morning. Now I get out of bed no problem.
- Decreased Appetite. This has really helped me with my over eating problem. I used to eat atleast 2 huge plates of spagetti at dinner time. Now its only 1 plate and there might be a little I have to dump in the garbage. So I am still able to eat, it has just helped me to not over eat. Hence I am starting to loose the pounds fast.

Cons
- Elevated blood pressure.
- Increased Anxiety.
- I had my first pannick attack the other day. (I'm pretty sure the increased blood pressure had something to do with this.)
- A few muscle twitches.

So how have I managed these symptoms? The doc prescribed me Guanfacine and it has eliminated all the bad symptoms caused from the adderall. My only issue now is I need my adderall dose increased because the guanfacine tends to overpower it and I can feel tired sometimes throughout the day.
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Old 11-03-07, 12:34 AM
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Re: Sluggish Cognitive Tempo (SCT)

I recognise myself totally in the SCT / ADHD-PI characteristics. There is one thing that I wonder about .. process information more slowly .. how does that work if your IQ is in the gifted range .. say > 130? Generally, a high IQ is associated with a proficiency in analytic manipulations .. isn't that the opposite of processing slowly?
I am trying to put into words how that works with me. Kinda hard. I find I am quite good at holding complex abstract ideas in my head. I can grasp those almost intuitively. But, at the same time, I have great difficulty to follow reasoning, like in math class. This last thing has seriously impaired my academic performance, especially after grade 8, and made it impossible to follow lectures. I dropped out of university after one semester .. despite being tested higly gifted and trying really hard.

I am curious how this works. In what sense is the ability to hold these ideas in your head differ from processing information? Does the working memory deficit that is mentioned play a role? (it feels like that might be the case)

And how is it with the fact that ADD people are said to have "many, fast thought, jumping all over the place" .. compared to this slow processing? I certainly feel like my brain is like a sped-up pinball machine, but somehow, *something* is slow and sluggish at the same time. I am physically sluggish/slow too.

@Jeremynd .. how's it going with the adderall?

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