Psychotropic medications prescribed frequently to children and adolescents for the treatment of anxiety, depression, and attention deficit hyperactivity disorder are reviewed. Pediatric pharmacological options based on double-blind, randomized studies are examined. We advocate that psychotropic medications be used only in conjunction with psychosocial interventions and that collaborative practices between medical and school professionals are essential. School psychologists play a critical role in medication management by monitoring behavioral, social-emotional, and academic outcomes, coordinating the intervention team, interfacing with the prescribing physician, and providing psychosocial interventions. (Contains 3 tables.)