Dr. X, A notable child psychoanalyst, from a notable academic institution says “I am OK with putting kids on Risperdal, because if it controls his symptoms, then I can do my work better.” My rage explodes internally. Putting kids on Risperdal is a major decision. There are long-term side effects which range from increasing cardiovascular risk factors to permanent movement disorders. There is no way that a self-respecting child psychiatrist can be carefree about prescribing atypical antipsychotics. Sure, some kids really need it so that they can stay in school and achieve academic and social success. Sure, some kids can go on Risperdal for short-term treatment, thus mitigating the long-term concern. Still, prescribing these medications come with serious consideration, which we, as child psychiatrists, need to join to say that we are focused on both short-term gain and long-term pain. Getting a child better is one thing, but we must also be concerned for the future of that child. We must think about prevention as well as symptom relief. Sometimes, I feel lonely in that regard, but I also remind myself that speakers often posture; they say things they don’t believe, to be both provocative and interesting. I bet that was true for Dr. X. It worked.