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Maybe he needs to try another medication. I have an 8 year old who is on Adderall 7.5-it works presently for him, but I've heard that meds can lose effect-or dose becomes ineffective. Not an experts opinion, but my  son went through similar behavior, effecting his school work and making him very self conscious and further aggravating his behavior. Most of all-we have kept a pretty standard routine and he is on a med currently to help him sleep-he wasnt before-he would be up most of night-2-3-4am-I was giving Benadryl-with some result-maybe fell asleep at 12am. This was not a side effect of his med as it is short acting and not extended release. Is your son sleeping? I have to say-my son is now a sweet, sometimes thoughtful child(Normal child), but still a boy who claims he hates his sister-but still likes to have sleep overs with her, and her company on trips..I was honestly considering(when eligible)sending him off to military school. I was not enjoying him-my son was just as you're describing your son-but, he would get mean,  even broke a window-among other things. Good luck. I was told by an adult psychiatrist that children with ADHD have trouble turning off-even when exhausted-the med my son's doctor prescribed is seroquel and though the desired effect has been obtained-I'm unable to find much info on it's use in kids. Sorry for going on and on-I am new to this site and feel like I am not alone. Thank you for listening.