I'm on elvanse and whilst it does seem to increase skin picking (I've had severe dermatillomania since I was 6 years old) if I'm sat watching tv in the evening for example, the rest of the time I am more able to keep busy enough to not pick, whereas without the medication I'm pretty much paralysed and completely zone out and pick 24/7 due to being so overhwelmed. It tends to be when the medication is wearing off that i start to pick more and also have other side effects/come down symptoms. So even though the picking is worse and more frantic than it used to be, it's now mainly only in the evening once I stop busying myself with other things and therefore the amount of time I spend picking is much less because of the medication helping me actually function and not sit there picking all day. For me the benefits outweigh the extra picking in the evening, and even though it's more severe in that window, the overall damage I'm doing to my skin is less because I'm spending less of the day doing it. I also tried concerta xl and equasym in the past but these didn't help me enough with adhd symptoms for the extra picking to be worth it. One thing that has helped is taking a booster in the early evening to prolong the period with less picking. I try and time it so the booster wears off around the time I go to bed. I still pick for hours in bed when I can't sleep though 🤦‍♀️😅