It usually is fairly obvious, but not a lightbulb moment. Sometimes especially hard to tell with non-amphetamines if they take a while to kick in like mine did, but amphetamines should be fairly easy to tell. I do know that everyone works differently, so if upping the dose again doesn't work you might want to try something different such as Adderall, or a non-amphetamine and see if it works better. It's not going to magically fully solve everything, you still gotta put work in (especially for executive dysfunction problems) but it should help a lot with focus, at least thats how it is for me.

Another thing is to maybe ask your doctor how best to take a short break to see how you feel on nothing vs the full dose closer together while paying more attention because slowly ramping up may make it hard to tell.

Btw, I'm on Quelbree (I think that's how to spell it) and it works ok for me, tbh I probably need to up the dose as well tho.

For me it was very obvious on day 1, both on Xaggatin (an offbrand concerta copy) and ritalin prolonged release. There was just a feeling of a bit more energy, clarity and drive - it was kinda how I felt on a really good day premeds, if I had a day where I was cheerful and excited about something, then the adhd symptoms weren't as bad as usual. On my meds, that's basically everyday now.

But I was on concerta for a while in between the other two, and found that they did very little for me. Even though Xaggatin and concerta are meant to be the same, and I was on the same dose, the concerta didn't really work for me at all (despite being more expensive!).

Is the plan to move to amphetamines if this doesn't work? Because concerta and the non-amphetamine drugs have very low success rates as far as I know. With amphetamines it's basically immediate

Some additional context, 25yo, 195cm tall, just under 90kg. Medication normally needs a bit more of an oomph to work on me, but I still expected some effect you know?

Picture an 4 way intersection.

For me every single car just went about their way all willy nilly like it was nothing.

Occasionally a semi hauling triple trailers flys through grinding every else to a halt when everyone is trying to get through.

There's no order, the lights don't work, and almost no one wants to yield.

The cars were ideas, things I saw, and things I needed to do. The semi is my latest hyper obsession. The non functional traffic lights were my ability to regulate my thoughts.

When I took my meds it was like the lights started working suddenly. At first they were really strict, one car at a time like a highway on ramp. But then things amped down a bit as I got more used to the meds. I even went up to 60mg atomoxetine from 40mg where I started as things ramped too close to chaos again.

I hope that made sense.

When the music turns off.

It took six months of adjusting medication to get to a dosage and medication that worked. Although, my doctor said that the amphetamine class of drugs were the only ones that really work; be it Adderall or Ritalin class of drugs. I was unable to take adderall and Ritalin has been near impossible to get, but vyvanse works great once I got on a high enough dosage. 60mg once daily. It’s about 2.5 hours from swallowing to full affect in me.

I am on Adderall, so not the same thing, but it was immediate. The constant noise in my head stopped for the first time in my life. I wasn't overwhelmed or overstimulated by my environment. I could hear the person I was talking to and my brain was able to filter out the rest of the world around me. I was able to sit and do a task I wasn't fully motivated to do. I was able to wait my turn in a conversation.

As time went on I had to adjust my doses and switched to time release, but I certainly know when I don't take them. Things evened out so it isn't quite as stark as that first year, but the difference is night and day. You still have to be aware of your behaviors and find mechanisms (behavior modification) to get past some of the other bits, but even just knowing what behaviors are due to ADHD help. Medication only gets you most of the way there.

One important thing to do is write down who the hell manufactured your medication each month. It matters. They are not all "the same". The efficacy and side effects can be completely different even though it is supposedly the same drug. Advocate for yourself and I am thankful my pharmacy works with me on getting the right meds and knows I am not crazy when I say it is different. Due to the shortage I am not able to get generic in the brands that don't mess me up, but I have found that the supply of name brand Adderall is stable right now and the time release curve is very smooth. I am lucky that I have the means and decent enough insurance to afford it.

To me though, it sounds like you may want to try a different medication. I know it is super stressful and seems like a big mountain to climb, but quality of life is important. You are important. Be vocal to your doctor and don't let them dictate what you do or do not feel.