Two patients diagnosed with dementia with Lewy bodies (DLB) presented with prominent behavioral disturbances. The first patient experienced well-formed visual hallucinations, movement disorders, and cognitive decline and was increasingly resistant to care. He was treated with galantamine 4 mg bid, which was increased to 8 mg bid after four weeks. Improvements in behavior, attention, and cognition made it possible for this patient to be transferred back to long-term care after 32 days. The second patient had increasing confusion, fluctuating cognition, agitation, and psychosis. He was given donepezil initially, then switched to galantamine 4 mg bid. He was assessed as stable for discharge with improved behavior control after three weeks. Both patients also were receiving an atypical antipsychotic (quetiapine) and an antidepressant (venlafaxine and sertraline, respectively).