Genetic and pharmacological studies have emphasised the role of serotonin 5-hydroxytryptamine (5-HT) as a possible etiologic factor in the development of attention-deficit hyperactivity disorder (ADHD). Tryptophan hydroxylase (TPH) is a rate-limiting enzyme in the biosynthesis of serotonin from tryptophan. Originally, the TPH gene was thought to be widely expressed, but a second form of TPH, TPH2, was recently identified and the TPH2 gene was found to be solely expressed in the brain. We examined eight single nucleotide polymorphisms (SNP) in the TPH2 gene for association with ADHD in 179 Irish nuclear families. Transmission disequilibrium test analysis revealed significant association between the T allele of marker rs1843809 with the disorder (v 2 Œ 12.2, P Œ 0.0006, OR Œ 2.36). Stratifying data by the sex of the transmitting parent showed that this association was enhanced when paternal transmission was considered (OR Œ 3.7). In addition, several haplotypes (all including the associated marker) were associated with ADHD. These preliminary findings suggest that TPH2 is a susceptibility locus for ADHD. Further confirmation, preferably from different ethnic groups, is required to firmly implicate TPH2 in the pathophysiology of ADHD. Molecular Psychiatry ( Keywords: attention-deficit hyperactivity disorder (ADHD); tryptophan hydroxylase (TPH2); transmission disequilibrium test (TDT); serotonergic system, genetic association Attention-deficit hyperactivity disorder (ADHD) is a common neurological disorder affecting 3-6% of children worldwide. 1 It is one of the most common causes of referrals in family practice, paediatric neurology and child psychiatry. 2 Children can be diagnosed with ADHD as early as 5 years of age with males being more affected than females (ratio ranging from 3 : 1-9 : 1). Major symptoms of ADHD include inability to sustain attention, hyperactivity, impulsivity and aggressive behaviour. The consequences are devastating for family and peer relations as well as academic life. Behaviour at home and at school is disrupted and ADHD children have poor school performance compared to healthy and age-matched children. 1 Symptoms persist into adulthood in at least 30% of cases. The disorder is clinically heterogeneous and its aetiology remains unknown. However, several lines of evidence have implicated genetic and environmental factors as predisposing to the disorder. Heritability of ADHD is estimated to be between 70 and 90%. 3,4 Environmental factors such as low birth weight, delivery complications, alcohol consumption and smoking during pregnancy, environmental toxins and diet are all implicated. 5 Serotonin 5-hydroxytryptamine (5-HT) is a neurotransmitter involved in a variety of functions such as attention, sleep, memory and learning, locomotion, control of appetite, anxiety and drug abuse. 6 Reduction in serotonergic function has been linked to ADHD symptoms such as aggression and impulsivity. 6,7 In addition, recent pharmacological evidence supports the potential involvement of serotonergic syste...