You build a tolerance but it never necessarily stops working if you use it correctly to help you build the compensatory systems that will help you manage things on or off meds

You have to build systems with or without the meds. Meds help you reinforce and ingrain those systems but you still have to be deliberate in practicing them.

There’s no point titrating beyond like 30mg of dex or whatever the equivalent is for whatever methylphenidate/amphetamine med you’re taking.

Almost undoubtedly, the ones taking more than that are overly relying on their drs to provide solutions only their working on developing these systems along with meds can provide. So many people on r/ADHD come across this way, they almost all seem like very newb ADHD people and they completely betray that about themselves with their recommendations and focus on titration and getting a higer dose and loudly declaring to everyone you’re ADHD. Often (unknowingly) they are chasing the initial euphoria which will never be a thing in the same way after a few weeks of continuous use which everyone eventually falls into.

Drs can provide the meds that can help you learn to manage and live, the meds cannot make you manage by itself if there’s no self-work on setting up systems to compensate for the deficiencies