BACKGROUND:Alzheimer's dementia (AD) occurs in 6 - 8% of persons older than 65 years. The prevalence increases to 30% among those 85 years or older. Among AD patients, the incidence of psychosis is 30 - 50%. Safe and appropriate use of psychotropic agents is a relevant clinical concern for this population. OBJECTIVE:This review addresses risks and potential benefits when risperidone is used for treating AD-associated psychosis. METHODS:Through literature review and clinical experience, the authors discuss the clinical efficacy, safety, and regulatory issues concerning risperidone treatment for this group of patients. CONCLUSION:Despite concerns about safety, risperidone remains a popular therapeutic choice for AD patients with psychosis. Subsets of these patients with more severe agitation and aggression may experience greater behavioral benefit.