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You mentioned the patient has diagnoses of attention deficit hyperactivity disorder (ADHD) and adjustment disorder.  “Many children with ADHD and their families struggle with oppositional behavior, conduct problems, and aggression” (Pringsheim, Hirsch, Gardner, & Gorman, 2015a, p. 42).  Tenex and Strattera are moderately effective for adjustment disorder, but stimulants are the most effective medications for children with ADHD and comorbid conduct problems, oppositional behavior, and aggression (Pringsheim et al., 2015a).  While risperidone has been shown to be effective in children and adolescents with below average intelligence, evidence to support the use of antipsychotics and mood stabilizers in children with these comorbid disorders is of low quality (Pringsheim, Hirsch, Gardner, & Gorman, 2015b).
References
Pringsheim, T., Hirsch, L., Gardner, D., & Gorman, D. A. (2015a). The pharmacological management of oppositional behavior, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: A systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine. The Canadian Journal of Psychiatry, 60(2), 42-51. doi:10.1177/070674371506000202
Pringsheim, T., Hirsch, L., Gardner, D., & Gorman, D. A. (2015b). The pharmacological management of oppositional behavior, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: A systematic review and meta-analysis. Part 2: Antipsychotics and traditional mood stabilizers. The Canadian Journal of Psychiatry, 60(2), 52-61. doi:10.1177/070674371506000203

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