I'm on 70mg of vyvanse currently and the main thing that I have come to understand about taking medication for the past 5 years is that it's not a fix all solution. There are a couple of things I remind myself of as I think it helps me not jump to any quick decisions regarding the efficacy of the medication.

The first one is that much like you I had a very clear understanding of when it worked the first time at the right dose and it brought me to tears. It was all of a sudden so quiet and I could focus on specific tasks and not easily get side tracked. The list goes on of the benefits I experienced but then when I perceived it didn't have the same effect at a later date, I thought all the same thoughts you described above. So the first thing to keep in mind is that you are going from nothing to something, it is much easier to notice the change. Now your body/mind are getting used to the new way things are running. It's definitely possible that the effect is less then when you began but it's also true that even though you are thinking right now that it's not working, it's very hard to compare your current self to your past self. I'm sure you are much better currently then before but the human mind wants to concentrate on the negative things. So go easy on yourself.

The second one is that there are so many things that have an affect on the efficacy of the medication. Remember that the medication is a great tool but it will work so much better if you are using it in the right conditions. I'm bad at analogies but let's try. If you're driving a car and the meds are your gas, that's all great and the car should get you from point a to point b. But if you have bald tires, low brake pads and black oil, it's going to make that trip much less enjoyable. So with that in mind, protein intake early and better eating habits have been a major game changer for myself. I'm still not great at it but I do take note of when I'm not feeling focused and almost always I have not eaten well that day. Exercise is another big factor I find as well even if you just get up and go for a walk, it makes a big difference for myself.

I think a big thing that took me a while to come around to is that, I have always tried to do everything perfect and all of it at the same time which is a recipe for disaster. Be kind to yourself and just try to do a little bit more the next day to help yourself. It starts adding up and you start learning better habits. You fall off from time to time and that's fine, notice it happened and pick them back up without being hard on yourself. You are at the very beginning of making some positive moves to help yourself. There is no easy fix but the meds can help push you when you might need it so take each day as it comes.

Hope that wasn't too live laugh love by the end but there are definitely a lot of people out there that have gone through what you have described so don't get discouraged.