The objective of this study was to collect data on outcomes obtained when switching elderly nursing home residents with dementia from risperidone to quetiapine. Medical records were reviewed to identify dementia patients switched from risperidone to quetiapine. Clinical Global Impressions (CGI) scores assigned retrospectively (at switch and weeks 4-6) assessed treatment. Data from 15 men and 52 women (mean age, 82.8 years) were evaluated. The mean daily dose of risperidone at switch was 1.42 mg. Switching was abrupt in all but 2 patients. The mean daily dose of quetiapine after the switch was 87.3 mg. After the switch, the CGI Severity of Illness score remained unchanged, but the CGI Global Improvement score was positive. Fourteen patients reported somnolence; 3 patients discontinued quetiapine. Most patients in this study were switched from risperidone to quetiapine with no worsening of clinical status.