Source
r/SCT•
randomuser025

Diagnosed with ADHD (PI), stimulants (at max dose) didn't work at all, but my psychiatrist doesn't believe in SCT. Should I give Strattera a shot?

I'm beginning to think my inattentiveness, brain fog, mind wandering and lethargy (which led to the ADHD-pi diagnosis) might be SCT. My psychiatrist, since he thinks there is no such thing as SCT, is sending me to psychotherapy now for ADHD (PI). He doesn't think Strattera will work (he cites studies showing it only helps ADHD a little bit at most), but I've been reading that Strattera might be good for SCT.

Thing is, my insurance doesn't cover Strattera or its generic version. Really expensive. I'd appreciate any feedback if I should push my psychiatrist into prescribing Strattera (or asking for a second opinion).

Posted Aug 7, 2020, 8:35 AM UTC

639
chouderz101•

If strattera is expensive for you , I'd suggest giving the creatine/glycine combo mentioned previously a try

5
dannydawiz•

Have you checked for sleep apnea or UARS. The symptoms overlap with sct and i thought I had it before but now i got mma surgery scheduled in 1 year

4
mightymiffADHD-PI•

MMA surgery? It is annoying for your audience when you use abbreviations they are unlikely to know what the hell they mean.

Also, linking effects of sleep apnea to SCT is also something I have neither heard nor read about. I do not doubt it may be the case, but it would be appreciated if you backed up your non-obvious claims with evidence.

5
miraclequip•

Yeah, MMA surgery is when you go into the octagon and somebody rearranges your face.

9
dannydawiz•

Maxillomandibular Advancement Surgery.

As far as linking Sleep Apnea to SCT I know I’m not the only one on reddit who thought they had SCT just to find out they had UARS.

Symptoms are overlapping. Poor memory retrieval Inattentive - ADHD Slow processing time. Trouble following directions.. Slow at finishing tasks. Comorbid depression and anxiety.

2
mightymiffADHD-PI•

As far as linking Sleep Apnea to SCT I know I’m not the only one on reddit who thought they had SCT just to find out they had UARS.

With UARS, you have always been this way? Have always been kind of cognitively slow?

Does it cause snoring or obvious sleep disturbances such that might be obvious to a sleeping partner?

1
dannydawiz•

Yes. I was born with UARS due to a grade 3 tongue tie which then led to a deficiency in the development of my jaw. This, in effect, led to postural compensations due to a restricted airway which causes chronic fatigue/pain throughout my upper body.

Born struggling to follow directions. Slow at finishing tasks. Not good at listening to people.

UARS can cause sleep disturbances such as sleep walking, sleep paralysis, sleep demons, restless leg syndrome, frequent awakenings at night, waking up sweaty or with your heart beating quickly.

I think what you’re referring to though is audible disturbances like snoring and pauses in breathing. It’s more common and easier to hear disturbances in sleep apnea patients because they have a higher tendency to snore. In which case your partner can listen out to hear if you snore with pauses in your breathing or if they can hear you choking on saliva.

1
unicornbomb•

dude, chill.

mma is essentially a type of jaw surgery that pushes the jaw forward. it helps alleviate sleep apnea in some people depending on the root cause.

1
mightymiffADHD-PI•

Thanks for the explanation. I know you are not OP, but you wanna tell us what the other obscure acronym is or how sleep apnea ends up looking like SCT?

dude, chill.

I will decline to take your advice on this point, thank you.

-1
unicornbomb•

sleep apnea can create a lot of the similar lethargy, brain fog, difficulty concentrating type symptoms as SCT.

UARS = Upper airway resistance syndrome, aka narrowed airway, especially when laying down. functionally almost identical to sleep apnea, just a different cause.

2
lblockh1•

Someone’s panties are in a wad. Also, lack of quality sleep most DEFINITELY causes SCT symptoms. Sleep quality is one of the first things a PCP looks at when almost any neurological symptoms are present in a patient. The thing is, most people lie and say they get quality sleep every night because they don’t think the two will be related. If you haven’t heard, or read about it, there’s a good chance you haven’t looked. The evidence is prevalent. Also, I could be wrong, but I don’t believe that there is an ICD-10 code for SCT (Sluggish Cognitive Tempo). There is, however, an ICD-10 code for SCT (Sacrococcygeal Teratoma). This is probably why the physician does not believe in the Neuro syndrome, SCT.

1
mightymiffADHD-PI•

Someone’s panties are in a wad.

Nah, they aren't. I did notice how you spelled out your non-obvious abbreviation.

My biggest concern relating SCT with sleep problems is explaining how it could become a lifelong problem. Because if your SCT came on suddenly or even gradually such that you could remember a time that you didn't have it, you probably don't have it. So, to be clear, the overlap in symptoms was not the major issue I was having though I worded that issue unclearly or wrong.

I did clear up a couple of misunderstandings from posters, though, that can lead to lifelong shit sleep (and thus a non-organic and lifelong appearance of SCT). I do not know prevalence statistics there, but I would imagine that this is relatively rare. If it isn't, why doesn't an ADHD-PI diagnosis require a sleep study?

Can you spell out your point about the terratoma thing more clearly? Ok, no ICD code for sluggish cognitive tempo and the same abbreviation, so what? (Edit: Nevermind, I got it. I usually just treat SCT as a subset of ADHD-PI for thinking purposes.)

1
dannydawiz•

I just wanted to add in regarding this.

“Because if your SCT came on suddenly or even gradually such that you could remember a time that you didn't have it, you probably don't have it.“

The symptoms of my sleeping disorder were more mild as a child. They didn’t start to become moderate until I became a teenager and they didn’t become severe until I became an adult.

My educated guess is that this is due to the development of my maxillofacial growth over time. I wasn’t born with a recessed jaw but as I got older that deficiency became more pronounced.

With that being said, ADHD symptoms were still the first to appear as a kid. There is a relationship between sleep deprivation and concentration issues. The only question is whether those issues are being caused by a sleeping disorder or if it’s a true ADHD/SCT patient.

1
handsomedanjung•

Where are the people that claim that fixing the sleep apnea or UARS cured their sluggish cognition?

I have a retracted jaw and bad snoring which would qualify me, but everyone I know people with terrible sleep apnea have no cognitive issues.

1
dannydawiz•

My experience is different. Most people I know with UARS and sleep apnea suffer from depression, anxiety, ADHD, or chronic fatigue. Keep in mind that UARS and Sleep apnea patients have overlapping symptoms but they’re still different. People can have different symptoms depending on the severity of the case.

Here’s one such case of a patient who had mma surgery to cure their apnea and saw their mental problems go away. https://youtu.be/Wm1y6nyqecA

Here’s another.

https://youtu.be/YWkSQ1nQF7k

This one is for a separate procedure called tongue tie release which is also meant to help fix sleep disordered breathing.

Pre-op https://youtu.be/bzuidYrXhPQ You can see how restless these kids are before the surgery.

Post-op https://youtu.be/7dAmu9mayUo Dad mentions his sons adhd has really calmed down.

Here are chronic fatigue patients with years of pain who saw their symptoms go away after the procedure.

https://youtu.be/bTleEkKJC5A

I don’t know if you consider that completely credible since none of the patients came forward as having sluggish cognition but many of them had pre-existing adhd which either disappeared after treatment or became much less severe.

2
handsomedanjung•

Thanks, but I am cynical towards those youtube endorsements, as I suspect those people were compensated somehow. Have you come across and testimonials on Reddit?

I saw many cases of people using the CPAP to overcome the oxygen deficit during sleep in which their brain fog is not improved. I wonder if this means that the damage from insufficient brain oxygen on account of sleep apnea may be permanent.

1
dannydawiz•

Yes. There was a girl here on reddit who was the one who told me about sleep apnea and UARS. She had ADHD and was on a really high dosage of adderall. She got treated with mma surgery to fix her sleep apnea and she was finally able to stop taking her stimulant medication. She’s someone I owe a lot too because she saw my struggles with adhd and suggested I had a sleeping disorder. She was correct and i wouldn’t be where I’m at without her.

Also, you’re more than welcome to remain skeptic. If it helps you feel better though then I’ll just throw it out there that Dr. Zaghi is my sleep specialist and he doesn’t compensate his patients for fake testimonials. When you sign up to be his patient he asks if you’re ok with him using photos/videos for educational purposes. These patients and their stories are real.

EDIT: Regarding CPAP, Many patients fail to see brain fog improve with CPAP because it is not the end-game solution for treating sleep issues. For many patients with UARS a CPAP is not effective. It can be completely ineffective for some patients depending on what the cause of their airway obstruction is.

Also, regarding permanent brain damage, I wouldn’t be too concerned about that. Most patients who I’ve seen get treated for the sleep problems see a remission of their symptoms.

1
dannydawiz•

Also, here is one of her posts.

https://www.reddit.com/r/SleepApnea/comments/999qk0/update_had_mma_surgery_3_months_ago_sleep_study/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

She talks a little bit about the remission of her symptoms in the comments.

You might also find this convo between me and a prior SCT patient interesting. He ended up having UARS like me.

https://imgur.com/a/cOXnIYA

1
HuntingRedOctober•

Yep. Those were ruled out.

1
TommyTuttle•

Try it. Psychologists often don’t want to prescribe strattera; mine said it only worked for about 3% of patients. But the fact is, you are highly likely to be in that 3%. If stimulants aren’t working then you’d better try the non-stimulant. Even if your psych doesn’t believe in SCT, Strattera can be prescribed for ADHD-PI and in this case it’s worth a shot.

3
MyExChexMyMain•

I haven't tried Strattera yet, my psychiatrist has me on armodafinil. I don't really think it's working, but we've increased the dose and are giving it a few weeks. If this doesn't pan out I'm going to ask about Strattera again.

I just wanted to add that you might be able to get strattera at a slightly more reasonable cost with goodrx. Not co-pay cheap, but also not $400.

https://www.goodrx.com/strattera

2
dannydawiz•

I believe strattera has an assistance program that will provide you the medication at little to no cost of you qualify.

I was on it at once which is how I know. I suggest you look into it.

2
bilbi_92•

This is my fourth day in strattera. First day was rough. Pretty intense nausea and hot cold sweats. The following days I made sure to take it after a decent breakfast and the symptoms were ten times better. I thought it was worth a shot. Apparently doesn’t kick in for a while but placebo may be to credit for feeling pretty stable in terms of my productivity and the rest so far.

Edit; peppermint tea helps A LOT!

2