My son is 6 and has similar challenges. We have tried Adderall XR and it was not a good fit for him. We’ve also tried a generic Methylphenidate, which was like giving him a sugar pill – It did nothing for him. What seems to work best is Vyvanse. Even with Vyvanse he’s still moody, has a poor appetite and difficulty getting to sleep but the benefits he gets from it far outweigh the negatives. We also tried adding Intuniv for the moodiness and crashes but my son became a zombie. It took his personality and that wasn’t worth it to us. We have not found the perfect combo and perhaps there’s not one Right now I try to address the issues one by one. The moodiness is just an ongoing battle I’ll admit and once I can get him into a therapist (NOT a virtual appointment!) I hope it will help us with this. Anger and moodiness definitely increases with hunger for him. I think his body feels off but he doesn’t recognize it as hunger because of the meds and instead it comes out as being short with us or angry. To prevent this I try to put food in his hands rather than asking if he’s hungry, asking just elicits an angry “NO” from him. I think “snacks” sometimes work better for my son than sitting for a meal. I find he will eat a lot more while watching a favorite show at breakfast or lunch – we don’t allow this at dinner. My son won’t eat his lunch at school but he will drink a shake! Grow & Gain shakes are great for school lunches. I get the organic because it has a lot less junk in it but your son is 9 and might find that “babyish”. If so, Carnation Instant Breakfast shakes have no artificial flavorings or dyes and are another good option. For bedtime, we use .05 mg of Melatonin. I know there are different schools of thought on this but for us his sleep is extremely important and if it’s what he needs to get it than so be it.
Also, have you removed artificial flavors and dyes from your son’s diet? This was huge for us!! When we did this for our son, the difference in behavior and ability to get to sleep at night was measurably improved. Red 40 and Vanillin (artificial vanilla) are my sons big triggers but we try to avoid all if we can. It’s not always doable, especially with Halloween and holidays. The Feingold Association website has lots of good info – so does ADDitude.
We’ve also been doing Play Attention for a few months now. It’s expensive and I’m not sure if it works or not. I feel like I see some small changes but who knows.
I hope some of this helps. This is hard – stay strong.