Explore a comprehensive grand rounds presentation on the evolution of treatment approaches for neuropsychiatric disturbances in dementia. Delve into the historical context, current practices, and future directions of managing behavioral symptoms in dementia patients. Learn about the challenges faced in medication development, the limitations of existing diagnostic frameworks, and the potential of novel interventions. Examine the universal nature of neuropsychiatric symptoms in dementia and their fluctuating patterns. Gain insights into eco-psychosocial interventions and the complexities surrounding antipsychotic use. Discover emerging hypotheses based on etiology and the promising avenues for future treatment, including targeted approaches addressing the heterogeneity of neuropsychiatric symptoms. Understand the interplay between serotonin system loss and Alzheimer's disease, and how this knowledge is shaping new therapeutic strategies.