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•The effect of a multidisciplinary intervention on the presence of neuropsychiatric symptoms, particularly agitation and aggression, and psychotropic drug use in nursing home residents with young-onset dementia was evaluated.•The intervention for the management of neuropsychiatric symptoms in nursing home residents with young-onset dementia was not more effective in reducing agitation, aggression, other neuropsychiatric symptoms, or psychotropic drug use compared with care as usual.•The perceived overlap between the intervention and current working methods and lower psychotropic drug use rates compared with approximately 10 years ago suggests that Dutch young-onset dementia special care units had already (to some degree) developed effective working methods for structuring the management of neuropsychiatric symptoms in young-onset dementia before implementation of our intervention.