Recent studies have shown an increase in antipsychotic prescriptions among children and adolescents. Virtually all pediatric use of antipsychotics is "off-label," meaning without a Food and Drug Administration indication. To make matters worse, pediatric antipsychotic usage can lead to serious side effects like movement disorders and metabolic disturbances. Hence, it is concerning that despite the virtual absence of long term efficacy and safety data, the widespread use of antipsychotics in children and adolescents continues. One important adverse effects of antipsychotic therapy is hyperprolactinemia. Prolactin is a hormone secreted by the central nervous system. The main action of prolactin in females is the induction and maintenance of lactation. The main action of prolactin in females is the induction and maintenance of lactation. Antipsychotic therapy has shown to raise prolactin levels both, in the adult and pediatric population. Sustained hyperprolactinemia can cause a number of endocrinological abnormalities leading to a hypogonadal state and eventually bone demineralization and osteoporosis. There is evidence linking pediatric prolactinomas to decreased bone density. Also, adult studies suggest that the high rates of osteoporosis in schizophrenia may result from hypogonadism secondary to antipsychotic induced hyperprolactinemia. Our concern is that the sequela of antipsychotic induced hyperprolactinemia in children and adolescents, has received little attention, despite the important implications for bone health. This topic is especially important because peak bone mass is achieved during adolescence and is a key determinant of the lifetime risk of osteoporosis.