Neuropsychiatric features of dementia are a common and significant burden on patients and their carers. Management usually involves a combination of pharmacological and non-pharmacological approaches. Antipsychotics are the cornerstone of treatment; among the atypical antipsychotics, risperidone is the most studied. Several trials have confirmed the efficacy of risperidone in the treatment of neuropsychiatric features in dementia, especially for agitation and psychosis. Recent concerns over an increased cerebrovascular adverse event profile and overall mortality with use of antipsychotics have emphasised the need for a risk-benefit analysis for individual demented patients being treated for neuropsychiatric features of their disease.