Mood and behavioral disorders in the course of dementia represent a significant clinical challenge. Although pharmacotherapy is widely employed, its efficacy is variable, and the available scientific evidence remains limited. The aim of this review is to synthesize current knowledge in this area. Literature analysis indicates that certain medications may reduce depressive, anxiety, or agitation symptoms, yet their use is also associated with an increased risk of adverse effects, ranging from sedation to serious cardiovascular complications. Consequently, pharmacotherapy should be applied primarily in cases where non-pharmacological interventions prove insufficient. The absence of unequivocal clinical guidelines necessitates individualized therapeutic decisions, considering the patient’s clinical condition and the safety profile of the treatment. To ensure optimal care for the growing population of patients with dementia, future research should focus on evaluating safety in the geriatric population, developing more selective therapeutic strategies, and integrating pharmacological treatment with comprehensive psychological and environmental care.