Before 1987, psychotropic drugs were rarely prescribed for children. When they were, it was largely to treat Attention Deficit Hyperactivity Disorder (ADHD). Since that time psycho- tropic drug use for children and teenagers has grown two- to five-fold, and the range of prob- lems for which they are prescribed has widened considerably. The increase of drug treatment has prompted concern from the lay public, investiga- tive journalists, and indeed some health profes- sionals. This concern should not be mistaken for blanket skepticism of all pediatric psychiatry: the drug treatment of severe and persistent mental illness (such as schizophrenia, obsessive compulsive disorder, or bipolar disorder) in late adolescence and early adulthood has been largely accepted. But when very young children receive diagnoses formerly reserved for late adolescence and adulthood, and when the drugs treating their diagnosed conditions have primarily been tested on older persons, it is not surprising that the rapid growth in psychotropic medication use in the young is met with concern and skepticism.