The benign side-effect profiles of the atypical antipsychotic drugs have earned them an important niche in old age psychiatry. Evidence for a specific improvement in cognitive function associated with the use of these drugs is inconsistent and the definitive studies are still awaited. If these drugs can improve cognitive function in elderly patients with schizophrenia and schizophrenia-like psychosis, then in terms of patient-years of effective treatment of cognition, this action may be more significant than the treatment of Alzheimer's disease with cholinergic therapies.