I understand that feeling, and the annoyance of having something insistent upon with treatment attached you’re not interested in. Hopefully the norm is dispassionate advocacy and dropping it when patients say no.

Acquired/adult ADHD is not as well studied and is usually secondary to other conditions, or correlated with long-term use of certain drugs like antihistamines for sleep, structural changes in the brain, etc etc. We don’t know enough. But if a patient have their own mechanisms that they say works, or thinks it’s temporary/habit-extinction/burnout, that’s the final word. Pushing rx management after that is unethical.