My Five Year Old (soon To Be 6 In May),

My five year old (soon to be 6 in May), is on Focalin, with prove nets at first. After a few weeks the dose was obviously not lasting so his second dose was moved up an hour. Then again he started having breakthrough symptoms and the dose was raised to 10 mg (3 X daily). Vyvance and Quillivant gave similar results.
He is very hyperactive, impulsive and has Opposition Defiance Disorder as well.
Is there a different medication or combination of medication that may help him?