EDITOR,—The report by Alice McGrath and Graham Jackson1 warrants further comment. They report that 88% of nursing home residents received neuroleptics inappropriately. They did not report psychiatric diagnoses nor reasons for the prescription. Mann et al found that nearly half the residents of local authority homes were receiving psychotropic medication, but also reported on the high levels of psychiatric morbidity among this group.2

Delusions and hallucinations are not limited to severe functional disorders but are common in dementia. They increase distress …