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I took the adderall xr for a few years and did fine, but once I became a mom of two two years apart, I needed a higher dose because I had more than just my own brain to distract me and stress me out. Everyday life was too overwhelming. I switched to the instant release tablets. I know I get a solid 4 hours of productivity and no anger outbursts after each dose. I now take 20mg twice a day and that is working well. I have traditionally low blood pressure, so that’s not been an issue for me. One thing I have noticed though, is that heart palpitations are usually caused by another medication in conjunction with the adderall – any other stimulants such as sudafed or anything with steroids. I don’t take these when I’m taking the adderall. A good provider who understands ADHD will not judge you for needing more help managing your symptoms. If your provider still pushes back you might need to find a new one. Don’t give up though! Once you find your optimum dose, life will be much more manageable. Good luck!