OBJECTIVE: To determine the prescription and over-the-counter (OTC) psychotropic medication and social drug (alcohol and caffeine) use patterns of community-based elderly caregivers of patients with dementia and elderly noncaregivers. DESIGN: Cross-sectional study design in which characteristics of psychotropic medication and social drug use were collected including the specific agent, frequency, dose, and reason for use. SETTING: A rural, sparsely populated agricultural area in the midwest region of the US. SAMPLE: Thirty elderly caregivers of patients with dementia were recruited through a public health agency and homemaker health aid service;Thirty elderly noncaregivers were recruited through the senior citizens center in a neighboring rural community. Data were collected by interview. RESULTS: A significantly greater number of caregivers used OTC psychotropic agents (43%) than did noncaregivers (3%; p < 0.001). In all cases these agents were used for sleep. The combined number of caregivers using prescription and OTC psychotropic products (63%) also achieved statistical significance compared with the control group (10%; p < 0.001), Caffeine was used by all members of both groups and alcohol was consumed by eight caregivers and seven noncaregivers. CONCLUSIONS: A greater percentage of rural caregivers of patients with dementia in this study took psychotropic agents compared with the noncaregiver group, OTC products for sleep were the most frequently used agents.