Medication problem?

I'm new to this forum but after doing a lot of reading about adult ADHD (and reading post after post on this forum), I am questioning the efficacy of the medication that my boyfriend is taking. I'm certainly NOT a psychiatrist, so I don't want to jump to any conclusions, but here is a little background:

My boyfriend was diagnosed with ADHD as a child. When he was young, he was incredibly hyperactive (like to the point that he would run around the house nonstop for hours completely bewildering his mother) and has been taking medication since then. He takes Adderall XR once a day, every day, and takes the non XR version of Adderall when/if he runs out of that. He is very good with taking his meds, because if he doesn't he says that he has trouble doing even the most basic things. In the time that I have known him, I've seen him very few times when he was unmedicated, and I can only compare it to someone who had been injected with some kind of energy serum. He jumped from place to place, was practically running around the apartment trying to do things...this was CLEARLY a different guy. It's almost like he was manic. Anyway, I say all of this to emphasize the fact that the Adderall DEFINITELY helps him, no question about that.

Even though the medication helps him, he still struggles with being disorganized, forgetting to pay bills, not being able to stop himself from interrupting others, not being able to focus on anything that doesn't provide him the utmost stimulation, having poor time management skills and really, really bad mood swings. All of these things really frustrate him, but everything that we've read has given great insight into what ADHD is (he really liked Dr. Russell Barkley), how to know if you have it as an adult, and why you should get medicated, but they don't tell him what he should do even though he IS medicated and he still has these issues. It seems like for him, being medicated makes it so that he can sit still long enough (literally) to function enough to even HAVE the problems I listed before. We have read countless success stories that talk about being able to focus once medication is introduced and seeing how ADHD affects the relationship, how it affects job performance, etc...I have read posts from some of you on here who have ADHD yourselves, and there is no WAY that my boyfriend could have the insight and focus that some of you have to tackle your problems because he describes feeling like he is in a haze just trying to hold onto everything spinning around him in his life. (and this is WITH medication!) This is a particularly stressful time - he works 70+ hours a week, we have been having major relationship problems, and he feels stuck with where he is - but even before all of these things happened, he still expressed concern over really not functioning as well as he always felt like he could. He tries really, really hard to make lists and set alarms and follow through with things, but it never seems to happen. I have my own issue with his behavior as it relates to our relationship but right now I just really want to ask - could it be that his medication isn't working or that he needs a different dosage? Like I said, he's been on meds since he was a small child, so I don't want to seem presumptuous in suggesting this, especially since we have been having problems, but he just doesn't seem to have the "I feel like I am out of the fog, a-ha" moments that so many people describe when they transition into taking ADHD medication. I know the medication isn't the cure-all, but it seems like it does more for others than it is doing for him right now...I don't know. Maybe it has to do with the severity of his ADHD.

Combined with all of that, his mood swings can be downright frightening to me. He has never been violent with me or anything like that, but it's scary because I feel like I don't know who I'm going to get on any given day. He doesn't get angry as much as he'll just be SAD and not wanting to talk and completely in his own head. Then if I can get him to talk, he's distraught because he doesn't understand why he feels the way he does and has the mood swings that he does, but he doesn't really know what to do about it. It's pretty much a given that on Sundays as he transitions for the next work week, I will just leave him alone because his completely distant behavior was causing us problems. I would get upset that he was so distant and was acting like I had done something wrong, he would get upset with me being upset, etc... He always snaps out of it and he apologizes (and believe me it doesn't just happen on Sundays), but it's certainly a problem. I've heard that Adderall can contribute to mood swings. He was taking an anti-depressant, but stopped over a year ago now (shortly after we met and in the height of our hyperfocus courtship) because he said he felt so much more stable than he ever had. Although I do EVERYTHING I can to be supportive, I think sometimes he blames his feelings on me. He thought his life was so much more stable after we met, and he stopped taking the anti-depressants, and now he's back to feeling so down. I wish that I'd known more about ADHD and depression and having a relationship with someone with ADHD back then because I would have insisted (back when he thought the sun rose and set in my eyes) that he stay on the anti-depressants, but I didn't. I realize that this isn't my fault, but that doesn't really help me to make him see that (especially when I ask him how he is feeling and he gives me the classic "I don't know").

Any thoughts?