People hearing the same thing over and over can be annoying to some, but for others it’s the only thing that’ll really get through a lot of our skulls and get us to try something different.
Doctors here are not aware of other medications and so I just smoke weed by the truckload :-)
Formulations with longer dose/release profiles exist - Concerta XR and Elvanse/Vyvanse are the same active stimulant (methylphenidate), but spread over the course of ~12 hours.
Personally I've found that Concerta has a ramping up and ramping down, with peak effects kicking in around 4 hours, whereas Elvanse kicked in relatively quickly at the same constant level.
Having to take ritalin (and adderall) multiple times a day with the risk of crashing in between sounds like a nightmare, and I'm glad at least here in the UK one of the first thing psychiatrists suggest trying is low dosages of the longer-acting methylphenidate derivatives.
It takes a lot of messing around with different meds and formulations to find one that works for you. It's like incredibly individual/personal; people seem to have wildly different responses to the different families of stimulants, different dosages, different delivery methods, different times of day etc etc. Takes a lot of educated effort.
It really sucks how it's so damn variable between countries or even within countries - national policies on ADHD meds and amount of knowledge your average doctor has in each country on those meds. Wildly and unhelpfully variable.
I've had Concerta, Medikinet and plain Methylphenidate and they all feel the same to me, it's the same chemical after all. Feels horribly nasty and I didn't find all the variables to make much of a difference unfortunately.
Medication and therapy are expensive. It doesn't always work. If it works, it might not work well. If it works at all, there are often side effects. Getting into therapy is hard. Finding a therapist you click with once you get through all the hoops is even harder. Sticking with each step of the process when you have a disorder that makes sticking to things hard is hilarious once you think about it.
And so on.