The editorial team has chosen the paper by Soto and colleagues which immediately follows this commentary in this current issue of International Psychogeriatrics, to be paper of the month. This paper reviews and discusses recent randomized controlled trials of drugs used in attempts to treat agitation and aggression in people affected by Alzheimer's disease.

An awful lot of pills get poured into people with dementia in the often vain hope that their behavior will be modified for the better. There is variability in prescription rates around the world and within countries that cannot be accounted for entirely by a widely different prevalence of behavioral and psychological symptoms of dementia (BPSD) from place to place, there is good evidence that a lot of these pills have the capacity to do significant harm as well as the potential to benefit some patients sometimes, there is not always compelling evidence of efficacy for some of the medications used in these circumstances, and there are other alternative management strategies available which do not require the prescription of medication and which may be of benefit to some patients in some circumstances (Ames et al., Reference Ames, Burns and O’Brien2010; Carrasco-Garrido et al., Reference Carrasco-Garrido, López de Andrés, Barrera, Jiménez-Trujillo and Jiménez-Garcia2013; Kröpelin et al., Reference Kröpelin, Neyens, Halfens, Kempen and Hamers2013; Seitz et al., Reference Seitz2013; Truzzi et al., Reference Truzzi2013; Atti et al., Reference Atti2014; Selbaek et al., Reference Selbaek, Engedal, Benth and Bergh2014; Testad et al., Reference Testad2014). If we think that particular medications may be useful to manage certain symptoms and syndromes in people with dementia, the least we can do is to evaluate them carefully and well in the patients and the settings in which they are likely to be used. Soto and colleagues have done the field, and our patients, a bit of a favor, by showing the heterogeneity of trial designs and the lack of consensus on syndrome definitions, choice of outcome measures and caregiver participation that still bedevil this field of enquiry despite years of research and despite the fact that huge numbers of people are afflicted with BPSD. As with so many aspects of old age psychiatry, we as a group of professionals could do better, and so we should – soon!