OBJECTIVE Little information exists on national trends in the use of psychotropic medication by children and adolescents. The objective of this report is to compare patterns and predictors of psychotropic medication use by children and adolescents in the United States in 1987 and 1996. METHODS An analysis of medication use data is presented from two nationally representative surveys of the general population focusing on children 18 years of age and younger who used one or more prescribed psychotropic medication during the survey years. Rates of stimulant, antidepressant, and other psychotropic medication use are reported. RESULTS The overall annual rate of psychotropic medication use by children increased from 1.4 per 100 persons in 1987 to 3.9 in 1996 (p < .0001). Significant increases were found in the rate of stimulant use (0.6 per 100 persons to 2.4 per 100 persons), antidepressant use (0.3 per 100 persons to 1.0 per 100 persons), other psychotropic medications (0.6 per 100 persons to 1.2 per 100 persons), and coprescription of different classes of psychotropic medications (0.03 per 100 persons to 0.23 per 100 persons), especially antidepressants and stimulants. Rates of antipsychotic and benzodiazepine use remained stable. In 1996, stimulant use was especially common in children aged 6 to 14 years (4.1 per 100), and antidepressant use was common in children aged 15 to 18 years (2.1 per 100 persons). CONCLUSIONS Between 1987 and 1996, there was a marked expansion in use of psychotropic medications by children, especially stimulants and antidepressants.