For decades there has been a high use of antipsychotic medication in nursing homes, though recently the use of typical antipsychotics has reduced while use of atypical antipsychotic medication has increased. The Australian government subsidises use of the latter in management of schizophrenia, and since April 2005 has subsidised use of risperidone (but still not the other atypicals) in cases of dementia with behavioural disturbance. This study was designed to examine the pattern of, and reasons for, antipsychotic use in a range of Sydney nursing homes.