When, if ever, do you consider increasing Adderall above the FDA-approved maximum daily dose of 40 mg for adult patients?

I titrate the dose based on the patient's needs, functioning, and tolerances.

I do go up to 60 mg of amphetamine salts if patients are tolerating it well, there's no treatment complicating behaviors like cannabis use, no other major comorbid conditions that may be contributing to symptoms (e.g., OSA), and there is a noticeable improvement in symptoms with dose increases.

I typically do not exceed dosages higher than FDA-recommended, particularly for adults, because of the risk of misuse. For adults telling me that only higher dosages have worked before, I still do not go above and rather suggest other approaches.