Productivity is not the most important thing to me— because it’s too easy to get the wrong things done.

It’s not really about productivity. Consider productivity an unintended benefit of the medication.

Extreme ADHD is a constantly shifting quest for volatile stimulation. This results in poor diet (extreme sugar cravings all the time), short term memory loss, failure to achieve basic tasks, obsessive behaviors, poor social framing, and more. For these extreme cases medication provides clarity that allows for more rational control of basic cognitive decisions.