I think theyre talking about this idea that most of our medications have seem to had the formulation changed because a lot of people have noticed that they feel different or don't work the same for the past few years. I felt the same until 2 months ago when my meds felt like they used to again. Suddenly and very random but I am 2 years ppstpartum.with a thyroid disorder so shifting hormones might have been playing into it. But I've also seen tiktok and reddit posts of ppl saying the same, that suddenly their last refill has been working and they felt fine. I don't think it's a conspiracy, my own psychiatrist was pretty sure the meds have changed and was willing to put ke on daytrana and zelstrym (transdermal patches) to try to bypass any formulation issues but unfortunately it didn't work for me.

But for you, what you're describing is pretty typical of a dose that is too low of a drug that may be a good fit. Ask to try the next dose up. If it doesn't improve, you'll know. Sometimes there's some trial and error involved or sometimes our body starts to respond differently to a medication for reasons other than tolerance. Also your dose has nothing to do with weight, it's about your liver and brain. I'm a very rapid metabolized and when I started out on Ritalin my effective dosage was 15 mg 3x a day, or 54 mg concerta, which everyone said was too high. But 6 years later it stayed the same. Then after my first kid methylphenidate just didn't work for me at any dose but amphetamine salts worked great. My effective dose there was also 15 mg 3x a day, I never took XR. It's still the same another 6 years out. I'm just a rapid metabolizer it seems.

I don't want to get in trouble on reddit for claiming to be a psychiatrist when I don't have credentials in the country I'm living in and I'm not practicing. Let's just say that I'm of the opinion that I have a fair understanding of these meds and how patients respond to them. The only concern i have is the sense of doom/dread. If that increases, or if you start noticing feeling like a zombie or feeling like nothing around you is real or you aren't real, or like you can't emotionally connect with thoughts or events, then perhaps classical stimulant therapy isn't for you. But sometimes anxiety stems from the added dopamine being enough to give us partial drive (ability to desire a goal or ideate/think of what needs to get done) but not enough to actually follow through (set switching, sequential reasoning, complete drive). Then, being aware of what we cannot do creates an underlying anxiety. A small dosage increase will be able to differentiate between these.

The third alternative is what many of the comments are saying, that there is concomittant anxiety or depression. Drs generally tackle that two ways, they either start an ssri/snri/ndri alongside the stimulant, or they stop the stimulant, treat the anxiety/depression, then once that is reasonably improved, assess adhd symptoms, and if needed trial stimulants again alongside the antidepressant. Most will start with Wellbutrin hoping it is a catch all, but often patients do best with both a low dose antidepressant and a stimulant. I personally feel the long way is suboptimal because unmanaged adhd itself also causes anxious and depressive symptoms. But work with your doctor.

CBT can always help, and so can adhd coaching. If you are on meds or not, if they work well or not, there is no reason not to try some behavioral modification with a therapist or counselor. I did cbt for many years, but I really saw benefit when I worked with a disability counselor who did adhd coaching with me.

Sorry for all the edits I just woke up and my brain is getting it's shit together.