Fathomless: While I won´t argue over years and such, I read recently that Nietzsche did fall into insanitys grasp a month or so after he had written "Ecce Homo". In retrospect then, one could claim that those titles were, if not indicative of full-blown insanity, at least showed that he was not entirely sane (I do believe delusions of grandeur are indeed a mental illness, if I´m not mistaken) and was headed for the loony peoples´ abode. Granted, I have not read the book in question, so I have no idea how serious the titles are to be taken. With past experience of Nietzsche´s writings, though, I assume they are to be taken as is and not with a grain of salt, pepper or any other such condiment.
I agree with your second paragraph, though; he has gotten a somewhat undeserved bad reputation (no thanks to the gigantic ´tasch, I´d bet) as a crazy man and not to mention the wrongful link to the nazis. But also, I think he has gotten a too good a reputation in certain circles. I have noticed that it has become common-place to quote Nietzsche from hither to thither, and while that in itself is not really that awful - as his writings have an abundance of great stuff to quote - I do feel that most of the time the quotes are just taken out of their respective contexts, and thus kind of lessening his standing as a serious philosopher and writer. Making him into a sort of pop-figure, if you will. Then, of course, one could discuss whether he was indeed a serious philosopher or just a writer with philosophical undertones, as his writings (the ones I´ve read, far from all, so I´m out on a limb here, I guess) had often not the characteristical argumentation and reasoning of philosophical works, but I´ll leave that to others to debate.