What did we do before psychopharmacology? I know, we parented.
The advent of ADD or ADHD is corollary with the advent of the practice of sticking our kids in day care. In 1986, there were only about 600 known cases in the US of either of these disorders, and when Ritalin started sponsoring the research into this disorder, what do you know, tens of thousands of diagnoses sprouted up. Sounds like a conflict of interest.
If a kid is not truly ADD or ADHD and we put him on drugs, those drugs can make him more hostile and psychotic. Zoloft is a nasty drug. I repeat, Zoloft is a nasty drug and if this child isn't mellowed out by what would send you or me through the roof, guess what, he probably isn't properly diagnosed.
Further, there is a difference between having this disorder and having a lot on one's mind. What was going on in the kid's life when he was diagnosed? Were you changing jobs, homes, partners? 4 year olds experience a flux of hormones not unlike puberty, not unlike menopause. It makes them moody and cranky. I will bet that's all it was.
I had a friend who was married to a family doctor. The doctor left her with three children and major stressers. The doctor left his family essentially for another woman. The kids acted out. The dad beat them. The mother beat them, to break their spirited ways (they were religious). And then they stuck the oldest on ADD meds, KNOWING he wasn't ADD because they didn't want to deal with him. Well, he started acting psychotic, starting fires and hitting back. They basically wrote the kid off as mentally ill.
Get your kid off medication. Get involved in his life. But make sure first you witness the detox of the nasty drug you put him on and become a responsible parent. Kids aren't perfect. And in dealing with life's little imperfections that we mature. We grow up. If we learn that if life isn't perfect we pop a pill...hmm.
It is a good idea to re-evaluate his medication regimen. He has been on an unusual combination of medications, and the variety and doses of psychostimulant medications he has been on is quite out of the ordinary. The doctor you recently visited was setting you on a good course. It may be wise, even though the school year has begun, to discontinue all medications and begin anew. It's hard to say at this point what is helping and what is not. The behavior you are witnessing is likely not psychotic behavior, and it can be symptomatic of both anxiety and hyperactivity. If it is related to the reduction in Zoloft, it could result from increased anxiety. One issue that should be addressed is the presence of the tic disorder and if this is associated with the large dose of stimulant medication he has been taking. The goal of weaning him off the clonazepam is sound.