Geriatric female with ADHD, has been stable on current list of medications. She takes her anti-hypertensive medication valsartan twice daily and Adderall 20 mg in AM and 15 mg at noon. Recently, she reports SBP and DBP increases of 20 mm Hg around 19:00. She also has L5MTHFR and L-carnitine deficiency. Clinically, she is stable and doing well. Her psychologist recommends stopping Adderall and switching to modafinil. Clinically, do not see much of a difference in blood pressure changes between the two agents. Did discontinue bupropion XL. Any thoughts would be appreciated. No medication changes made other than stopping bupropion XL last week which has reduced blood pressure minimally. When patient measures her blood pressure it is within normal limits throughout the day