Many psychotropics prescribed to children are unlicensed or off-label. This article uses the two most prescribed psychotropics (MPH and SSRIs) to illustrate various concerns about their impact on youth. Many mental illnesses begin in childhood or early adulthood, warranting a treatment of some kind. However, commentators have argued that prescribing is influenced by five myths: (1) children are little adults; (2) children have no reason to develop depression or anxiety; (3) psychiatric disorders are the same across adults and children; (3) children can be prescribed lower doses of the same drug; (5) drugs are preferable to alternative treatments and are more successful. Several lines of evidence suggest that these are incorrect assumptions. We update readers with recent research in relation to these myths, concluding that researchers should clarify child/adult differences for psychotropics, attend to the growth of "cosmetic" use of psychotropics in children and adolescents, and address concerns about the diagnostic validity of mental illness in the current DSM classification system.