Conduct Disorder

M.E. (Amir) is a 7-year-old male referred by his therapist for pharmacotherapy evaluation, primarily for ADD. He has a significant trauma history — removed from his mother at birth, placed in multiple foster homes for 3-4 years, then returned to her custody. He was recently discharged from an inpatient facility; records are unavailable. His therapist corroborates his mother's report of concerning racial ideation, which the mother attributes to the inpatient stay. Prior medication trials include amphetamine salts, aripiprazole, risperidone, and trazodone with no reported benefit. He is in an alternative low-ratio classroom setting and is noted to be wearing pull-ups at the time of evaluation.