Doctor unable to figure out next steps of treatment..

Hey! I have been routinely seeing the doctor for the last 2 years now every 6-8 weeks, starting with escitalopram/concerta/ritain/biphentin/vyvanse/adderall/ritalin/stop escitalopram but added venlafaxine/mirtazapine for sleep/vyvanse 60mg. So as of today, I am taking 60mg vyvanse, 150mg venlafaxine and 7.5mg mirtazapine for sleep. The last 2/3 months I have noticed a major improvement overall in nearly every area of my life, however in the process, its as if my perspective changed from "having bad days to good days" to "bad days, good days, great days". As if I have had moments that I truly felt free, and felt significantly better the most other days. However this doesnt last, and I am faced with inconsistency in my day to day life as each day I feel completely different. There doesnt seem to be any reasoning, I am sleeping better, eating better, more mindful and aware, less distractable etc but I find myself becoming irritated more, I have ideas that I couldnt comprehend before, although still have issues following through, and my long term planning is sti essentially shot - out of sight out of mind - I can spend all day setting something up or researching something, preparing for it, and boom I give up. I still want to do it or whatever, but now its not important and theres other things to do. My issue stems from the fact my doctor has admitted he is unsure of what to do next. Hes agreed there has been improvements on all 3 medications, however is hesitant to continue bumping up as it seems there could be underlying issues, or it could be side effects of too high a dose. Hes not well trained in adhd distinctly so although he can identify and treat it, he isnt able to fine tune doses correctly. He had stated my best option is to wait 8 more weeks and go from there, but now that I am feeling the way I am, I feel as if im stuck in the middle. What am I supposed to do now?