OBJECTIVE： To observe therapeutic efficacy and safety of aripirazle or risperidone combined with donepezil in the treatment of Alzheimer disease. METHODS： 46 patients with alzheimer disease were randomly divided into control group （n＝24） and experiment group（n＝22）. Both groups received routine treatment， donepezil 5 mg， qd； control group was additionally given risperidone 1 mg， increasing to 2-4 mg， qd， according to disease condition； experiment group was additionally  given aripirazle 10 mg， qd. Both groups were given 8 weeks of treatment. BEHAV-AD score and PSP score of each indicators in 2 groups were recorded before treatment， 2， 4， 6 and 8 weeks after treatment， and TESS score were compared between 2 groups. RESULTS： After treatment， BEHAV-AD score of 2 groups decreased significantly， especially in experiment group，  with statistical significance （P＜0.05）. After treatment， the score for aggressive behavior， conduct disorder， depress and anxiety in experiment group were much lower than that of control group， with statistical significance （P＜0.05）； there was no statistical significance in crankiness， hallucination and deliration score （P＞0.05）. After treatment，PSP score of 2 groups elevated markedty， the test group increased more significantly，with statistical significance（P＜0.05） ADR score of experiment group was significantly lower than that of control group， with statistical significance （P＜0.05）. CONCLUSIONS： Both aripirazle or risperidone combined with donepezil is effective for Alzheimer disease， and aripirazle combined with donepezil shows more definite efficacy and better safety.