OBJECTIVES: Stimulants are recommended first-line treatments for attention deficit hyperactivity disorder (ADHD), but increased use of other psychotropic medications such as antipsychotics and antidepressants has been reported. However, recent nationally representative estimates are lacking. This study examined the recent trends in use of psychotropic medications among children with ADHD in the US. METHODS: This retrospective study utilized the data from Medical Expenditure Panel Survey for the years 2002-2010. Trends in use of psychotropic medications (stimulants, antipsychotics, antidepressants, anxiolytics/sedatives/hypnotics, mood stabilizers and clonidine) were examined. Unadjusted logistic regressions were conducted to assess the significance of trends in medication use over time. Logistic regressions were conducted to identify the socio demographic characteristics and comorbid psychotic disorders (schizophrenia, bipolar disorder, depression/anxiety, autistic disorders) associated with the use of each psychotropic medication class. RESULTS: Use of stimulants was most common during the study period, which increased sharply from 43.0% in 2002 to 80.8% in 2006 but decrease afterwards to 62.2% in 2010. Use of antidepressants accounted for 10.4% and with no statistical significant trend over time annually. Antipsychotics was used for 9.3% of ADHD children annually but increased in recent years from 7.2% in 2002-2004 to 11.3% in 2008-2010 (OR: 1.6, 95% CI: 1.1-2.6). Having schizophrenia (OR 26.6: CI 2.95-239.6) or bipolar disorder (OR 20.1: CI 12.3-33.1) significantly increased the use of antipsychotic medication in children with ADHD. CONCLUSIONS:  Stimulants remained the mainstay of treatment for ADHD in children, although its use decreased after 2006 which is consistent with other studies. Antipsychotic use was less common but increased significantly in recent years.