The current literature on the pharmacological treatment of dementia was reviewed and the strength of evidence for the efficacy of each drug was categorized using an evidence-based approach. Acetylcholinesterase-inhibitors represent the only category of drugs with consistently demonstrable efficacy in well-designed studies of Alzheimer's disease, although the effect is not large. There is a lack of prospective, controlled, randomized studies for most of the nootropics. Epidemiological evidence suggests prophylactic effects of oestrogens and anti-inflammatory agents, and a single large-scale trial suggests that long-term administration of vitamin E or selegiline may be associated with improved outcome in patients with Alzheimer's disease. A number of drugs were reported to be effective in the treatment of non-cognitive symptoms of dementia including classical and atypical neuroleptics, antidepressants and anticonvulsants. The evidence for efficacy, however, is not strong for the majority of these compounds.