I'm not a doctor but I have a good guess as to what you're experiencing. First off, have you tried Vyvanse? As far as I know it has the most stable effect over time of any of the extended release formats. This means you get a less drastic spike after initial dosage, usually 30 min to an hour, and the effect is pretty steady for 8 or so hours. You should give it a try.
Regardless it sounds like you have built up high tolerance, which isn't surprising to me. If so, then the reason you believe your current dose isn't lasting is because you're used to that initial spike in effect. I've been there.
What works for me is to take a hiatus. Maybe a week or two if you can get away with it. Then start at a lower dose. In the past I found increasing the dose through the week and then taking a break or a reduced dose on the weekends would help fight tolerance. Avoid caffeine and other stimulants when you're on your regular dose.
If you haven't tried Vyvanse, then I encourage it. You'll want a much lower dose. Start with the 10 mg once a day and titrate up by 10mg every one or two weeks. Taking a hiatus first is a good idea otherwise you might misjudge the dose.
I currently have 40s and 10s and 40 on a Monday kicks my ass, 50 on a Friday is hardly noticable, but I take the weekends off (or 10 or 20mg each day if I need to get shit done) and the following Monday 40mg will kick my ass again.
In terms of the other things, not much you can do other than plan around the effects. Best of luck.
Good you mention Vyvanse, I need to get the ball rolling on that. Asked my GP about it a while ago, he referred me someplace for the initial prescription and titration process, but then that place stopped taking on new cases before I had a chance to set mine up. Looks like they since opened back up with a 6 to 8 months waiting list.
Tolerance and/or the "honeymoon phase" are solid mentions, but neither is at play here. Inconsistent Methylphenidate effects have been a thing for me from the very beginning. No amount of exercise, diet changes, de-stressing, lower dosages, or even month-long break have had any effect. Seems completely random, it's just weird!
Regardless it sounds like you have built up high tolerance, which isn't surprising to me. If so, then the reason you believe your current dose isn't lasting is because you're used to that initial spike in effect. I've been there.
What works for me is to take a hiatus. Maybe a week or two if you can get away with it. Then start at a lower dose. In the past I found increasing the dose through the week and then taking a break or a reduced dose on the weekends would help fight tolerance. Avoid caffeine and other stimulants when you're on your regular dose.
If you haven't tried Vyvanse, then I encourage it. You'll want a much lower dose. Start with the 10 mg once a day and titrate up by 10mg every one or two weeks. Taking a hiatus first is a good idea otherwise you might misjudge the dose.
I currently have 40s and 10s and 40 on a Monday kicks my ass, 50 on a Friday is hardly noticable, but I take the weekends off (or 10 or 20mg each day if I need to get shit done) and the following Monday 40mg will kick my ass again.
In terms of the other things, not much you can do other than plan around the effects. Best of luck.