The objective of this study was to investigate the patterns in prescribing of psychotropic drugs for children and adolescents within the psychiatric department of a general hospital in China. Medical records of 878 patients (0–18 years old) were reviewed in 2000, 2005 and 2010. Patient characteristics, total psychotropic drug use and the proportionate use of each drug class (antipsychotics, antidepressants, mood stabilizers and anxiolytic–hypnotic drugs) were analysed. The results indicated that there was a 19.2% increase in the overall use of psychotropic drugs during the study period. The use of selective serotonin reuptake inhibitors increased from 24.8 to 45%, whereas that of tricyclic antidepressants decreased from 17.7 to 0.5%. The use of second-generation antipsychotics increased from 56 to 80%. In contrast, the use of first-generation antipsychotic decreased from 26.2 to 6.5%. The use of valproate also increased significantly from 2.1 to 16.4%. In patients diagnosed with schizophrenia, the use of selective serotonin reuptake inhibitors increased from 1.2 to 18.9% and that of valproate increased from 0 to 12.6%. The increasing trends in psychotropic drug use necessitate addition research to confirm their safety and efficacy in this specific population.