My friend… you are not alone. As an ADHD guy… I’m getting ready to go to breakfast with my folks… <grin> I could share my story which has some similarities and differences… but cutting to the bottom line…
1. You are absolutely right!
2. Thank you for sharing–I feel much better about the situation I’ve been having (Having been diagnosed with adhd for 35 years now…but as an adult I’ve had more evolved symptoms if you will)
3. Has your physician considered something more time-released like concerta? It has helped me immensely… 
4. Have you tried a bit of caffeine with your old dosage–nothing drastic–just a cuppa tea/coffee or two with or after the pills–I’ve found that it does work for me on some of those more challenging days… (from my pediatric neurologist who I’m now 42 and am still working with because he responded when I was 22 to the following…)
5.Have you considered trying to locate another local physician who is “in your plan” who is more competent to deal with medication adjustment?
6. Conversely, have you been VERY BLUNTLY DIRECT with this doctor saying the magic words, “Look, I like you, I appreciate your help–BUT my life at the end of the day spirals out of control and I NEED YOU TO HELP ME OR REFER ME TO SOMEONE WHO WILL.” (or something more reflective of how you feel… That’s difficult–if you happen to be feeling “ok” at the time of your appointment it’s difficult to tap into the frustration you feel at the times when you’re not–so you MAY need to rehearse it before you go in–or you may need to write it to him/her in a note saying the same thing and hand it to him when you come in. If this guy/gal starts off on something like “I don’t want you to become dependent on the drug” or some other crap. Use him as long as you need to to maintain your current progress, and actively shop for someone who has been adequately educated on the protocols and long-term study.
Wishing you all the best and hoping I haven’t offended… (Because, I can be far too blunt and direct, and you deserve a respectful, caring response! which is my intent.
Finally, I’m really happy for you that you’re having some success with this!)
–Dave
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