Since Bradley's report in 1937 that described the efficacy of racemic amphetamine sulfate in the treatment of children with disruptive behaviours, numerous studies have documented the safety, efficacy and tolerability of psychostimulant treatment for children and adolescents with attention-deficit/ hyperactivity disorder (ADHD). Stimulants should generally be considered first when initiating pharmacotherapy for most patients with ADHD, but as a part of a multimodal approach of ADHD. The most commonly prescribed and studied psychostimulants include methylphenidate (RitalineReg.), dextroamphetamine (DexaminReg.), recently methylphenidate OROS (ConcertaReg.) and mixed amphetamine salts (AdderallReg.). The lack of pharmacologic coverage throughout the school day may account for the apparent failure of stimulants to affect some key domains of functioning in children with ADHD. Recently sustained-release preparation of psychostimulants have been developed (Ritaline SRReg., Ritaline LAReg., ConcertaReg., Adderall XRReg., [methylphenidate HCI] Metadate CDReg., [dextroamphetamine] SpansulesReg.). Since January 2003, the atomoxetine (Strattera Reg.) with the pharmacological profile approaching an antidepressant is approved by the FDA in United States for children and adults with ADHD. Preliminary data suggests comparable efficacy to stimulant across the ADHD symptoms spectrum without predictors available for who responds better to stimulants versus atomoxetine. The efficacy of other non-stimulants is until now not enough documented (for instance, alpha 2 agonists as clonidine, tricyclic antidepressants as desipramine and nortriptyline, SSRI as fluoxetine, bupropion or modafinil).The medications are second choice alternatives for problematic cases. The prescriptions for ADHD symptoms are under the responsibility of clinicians (usage "label off"). The purpose of this paper is to briefly review the available data about the pharmacotherapy of children and adolescents with ADHD in order to provide the clinician with rational, empirically based strategies. This paper especially describes the medications available in Switzerland, as the short- and long-acting RitalineReg., DexaminReg. and ConcertaReg.. The effects of slow-release preparations of methylphenidate are reported. A persistent question attached to ADHD is the allegation that stimulant therapy can lead to substance abuse or drug addiction in either adolescence or adulthood. This paper briefly reviews the available data about this topic. Scientific data have shown that there is no evidence at this time that long-term treatment with stimulants or other psychoactive drugs prescribed for the treatment of children or adolescents with ADHD is associated with high rates of substance abuse later in life. During the past decade epidemiologic studies have documented high rates of psychiatric comorbidity among children with ADHD, as conduct disorders, oppositional defiant disorders, anxiety disorders, mood disorders and learning disabilities. If not recognised and not treated, the combination of comorbid symptoms and ADHD may lead to high morbidity and disability with poor long-term prognosis. The choice of the currently available drugs in Switzerland is still limited, and the clinician is in an unpleasant situation when the effectiveness of the methylphenidate is insufficient or patients develop problematic side effects. The clinicians in Switzerland await with interest the introduction of new preparations of psychostimulants, as the methylphenidate OROS (ConcertaReg.) or Ritaline LAReg. wich have an action of long duration, or the atomoxetine (StratteraReg.) with the pharmacological profile approaching an antidepressant. The introduction of other preparations already marketed in the United States could widen the pallet of drugs indicated in the treatment of the ADHD in the child and the teenager. (PsycINFO Database Record (c) 2005 APA, all rights reserved)