I agree with the views expressed by Treloar et al ^{Reference Treloar, Crugel, Prasanna, Solomons, Fox and Paton1} regarding antipsychotic use in dementia. This is not only an ethical dilemma, but an issue of medical prescribing practice that has entered public and political domains. The present widespread use of antipsychotics seems to be unjustified but the emphasis should be on more rational use of these medications rather than an either/or debate. Our focus should be to develop policies and protocols which can lead to justified use of antipsychotics, with continuing reviews of the need for these medications. Their editorial is a step in right direction.

It seems that antipsychotic use in dementia is being demonised in the media. ^{Reference Hope2–Reference Triggle4} Policy makers are also pushing for a decrease in their use. I have two issues with the direction this debate is taking us. First, I hope the pendulum does not swing so far in the other direction, that psychiatrists find it hard to prescribe the medication even to those who will benefit from its use. ^{Reference Brummel-Smith5} Second, although the main push seems to be towards reduction of antipsychotic use, less is said on how to develop the resources that can provide good non-pharmacological approaches. Audits and targets should not solely focus on the quantity of antipsychotic use in dementia but also on the quality of non-pharmacological approaches available to this population. Long strides are required in this direction to improve behavioural and psychological symptoms of dementia care in the community, hospitals and care homes.