Adderall no longer working

I am a 40 yo woman who has had ADHD since childhood. I was rx Ritalin as a child, later being on concerta. I do not remember how these medications affected me, but I seem to recall feeling numb on the concerta, which may be why I stopped taking any medication for most of my adulthood. Fast forward to now, after being a SAHM for a decade, I have a full time job in a creative field and my ADHD symptoms have gotten progressively worse. I began a regimen of Adderall XR, which worked well for a couple of years with periodic increases in dosage. The last few months, the 30mg dose was no longer effective at all. My Dr prescribed IR 20mg/2x per day. Day one I felt very normal, and hopeful. The last couple weeks have been hell. Manic excitement and an inability to control myself in social settings, work meetings etc with frequent interruptions. I have an appt today and am scared of what’s to come.

I tried vyvanse last year, but it felt as though I had taken nothing at all. I wonder if the dose was too low, however; I went from Adderall XR 20mg to Vyvanse 20mg. I switched back to the Adderall a month later.

Should I try the Vyvanse again at a higher dose? Something else entirely?

Comorbidities are depression and high BP, both well controlled.

I’d love to hear your experiences!