Objective To investigate the efficacy and safety of atypical antipsychotics in treating behavioral and psychological symptoms of dementia (BPSD).

Methods A total of 118 dementia patients with BPSD were randomly divided into control group (n = 32), risperidone group (n = 22), quetiapine group (n = 29) and olanzapine group (n = 32). After 16 weeks of follow-up, negative polarity item (NPI) was used to evaluate the drug efficacy; Mini-Mental State Examination (MMSE) was used to assess the cognitive function of patients; Activities of Daily Living (ADL) was used to assess patients' daily living ability; Treatment Emergent Symptom Scale (TESS) was used to evaluate drug-related adverse reactions.

Results The NPI scores at each visit site in the olanzapine group and quetiapine group were significantly lower than those in the baseline period (P < 0.001); the NPI score at the end of eighth week in the risperidone group was significantly lower than that baseline period (P < 0.05). The scores of ADL, Instrumental Ability of Daily Living Scale (IADL) and Physical Life Self-care Scale (PSMS) in the control group at the 16th week were significantly higher than those in baseline period (P < 0.05). The incidence of dry mouth in the risperidone group was significantly higher than that in the quetiapine and olanzapine groups (P < 0.05).

Conclusion The BPSD of dementia patients in the risperidone group, quetiapine group, olanzapine group and control group is improved. The efficacy of the three drug groups is better than that of the control group, and the efficacy of the olanzapine group and quetiapine group is better than that of the risperidone group. There is no significant difference in safety among the three drug groups. In addition, treatment with atypical antipsychotics may help relieve BPSD's damage to the daily life ability of dementia patients.