Over the past decade, there has been a rapidly increasing interest in the use of medications to treat children and adolescents with psychotic disorders. At times children and adolescents present with comorbid disorders or are resistant to traditional treatments. These patients are a significant challenge to the treating child and adolescent psychiatrist. This Institute goes beyond the basics of first-line treatment and provides a high level of understanding with regard to the use of medications in complicated child and adolescent psychopathology, including refractory ADHD, major depression, bipolar disorder, posttraumatic stress disorder, substance abuse, anxiety, obsessive compulsive disorder, and autistic spectrum disorders. By evaluating positive and negative studies of pharmacotherapies and exploring the current use of medications in the pediatric population, attendees are better able to identify treatment options for comorbid and refractory children and adolescents in the clinical setting.