I'm usually able to just take my AM dose of instant-release meds. I can kick myself into hyperfocus, work through lunch (at least), and then do less intensive stuff in the afternoon if I'm burned out, or just continue with the hyperfocus session if I'm not. By about 2pm the meds have worn off but I'm in "productive" mode and I usually manage to keep going until 5ish.
The only real downside for me is I'm much less physically active this way - I don't get up and wander around to chat with someone (if I'm in the office) or go for a walk to clear my head. So there's definitely some physical activity debt that builds up when I'm medicated.
His appointments to e.g. the FCC suggest that he's not opposed to progressive voices and is willing to put them in positions of power. Would I like him to be even more to the left? Sure, but he has to actually govern, so I think he's doing a pretty decent job balancing the demands of the situation.