Your situation is very similar to mine. I started at 216 two months ago and am down to 186, same medication. My suggestion would be to pick a fasting schedule (I’m doing OMAD with occasional 24-48 hour fasts depending how I’m feeling) and light workout routine you can stick to for multiple months at a time without getting burnt out or bailing on it. For weight loss, long term commitment to a sustainable fast vs periodic long fasts has been much more successful for me personally. Medication hasn’t been a problem, I think the mood/focus/energy levels when fasting will dip and it’s just something you gotta get accustomed to, it will slowly become less pronounced over time. Oh, also take a short 15 minute walk at the end of the day (for me it’s after my meal) and if you’re ever having a bad day instead of giving up, just skip the workout and/or shorten the extended fast goal instead, it’s better you stay on track long term than be too strict and fail. Best of luck to you, the longer you make it the easier it gets, I’m sure you’ll do great.
For ADF or 36-hour fasts, I don’t see much of a difference in terms of my ADHD/Adderall dosage. For longer fasts though, I find that on day two or three, I have to cut back on my Adderall dosage. Other than that though, I haven’t had any issues taking my medication while fasting.