I don't think it's a side effect of any medication. Does the medication seem to be helping, four is young to be diagnosed with ADHD. He could have other issues from being adopted not from birth, who knows did he bond, did he have socialization in Korea??? Lots of questions???
Conscientious doctors do not diagnose a four year old with ADHD. Children that young are in an early development stage. Most doctors would never make such a diagnosis until the child is older - may six or seven. Given that he should not be diagnosed with ADHD, he should not be on medication. Whether the medication is causing this behavior, I have no idea, but I would find another doctor and get him off the stuff.
Definitely a side effect of something he has seen or heard. Doubtful if it is a side effect of the medication unless it comes with some very weird illustrated directions.