Pediatric Psychopharmacology turns evidence and safety rules into a clinic-ready playbook for children and adolescents. Medication is powerful—but only when diagnosis, impairment, and context are clear. Begin with developmentally tuned assessments, teacher and caregiver input, and first-line psychotherapies when indicated (parent training, CBT, ERP, school supports). When medication is warranted, use shared decisions with the child’s voice included: set functional targets in pediatric psychopharmacology conference  (morning routines, classroom attention, fewer meltdowns, sleep continuity), agree on timelines, and map what success looks like at home and school. Start low, go slow, and check in often; track sleep, appetite, growth, vitals, and cognition in plain view on a registry that the whole team can see. We outline reliable pathways for ADHD (stimulants/non-stimulants and when to switch), anxiety disorders (SSRIs with exposure coaching), OCD (SSRIs aligned with ERP), depression (CBT/IPT first when feasible; SSRI with careful monitoring), bipolar spectrum (mood stabilizers/atypicals; avoid antidepressant monotherapy), tics/irritability, and autism-related challenges. Polypharmacy creep is the enemy; deprescribe deliberately when benefits aren’t clear. School is part of the treatment team: 504/IEP accommodations, dosing schedules that respect class and sports, and teacher feedback loops that make progress visible. Equity features—interpreters, low-literacy materials, tele visits, pharmacy coordination, and cost navigation—turn prescriptions into consistent access. Safety is specific: suicide risk screens, substance use checks in teens, and monitoring plans for rare but serious side effects. When treatment stalls, look first at sleep, routines, therapy alignment, and family stress before stacking complexity. The goal is more than symptom reduction; it is capability—attention that holds in class, evenings with fewer battles, friendships that stick, and a body that sleeps, grows, and learns.