A randomised, double-blind, parallel-group comparison of the efficacy and the safety of venlafaxine versus nortriptyline in the treatment of depressed elderly inpatients.

1. Male or female inpatient;

2. Aged 60 years or older;

3. Meet the DSM-IV criteria for major depression, single or recurrent episode (296.2x, 296.3x), dysthymic disorder (300.4), mood disorder due to a general medical condition, with depressive features or with major depressive -like episode (293.83), substance induced mood disorder with depressive features (292.84), depressive disorder not otherwise specified (i.e. minor depressive disorder) (311);

4. Have a baseline MADRS total score ? 20;

5. Have a baseline MMSE score > 15;

6. Written informed consent.

1. Known hypersensivity to venlafaxine or nortriptyline;

2. Previous unsuccessful treatment with venlafaxine for at least 4 weeks with a minimum dose of 75 mg/day or previous unsuccessful treatment with nortriptyline for at least 4 weeks with a serum level within the therapeutic range;

3. Relevant medical illness which is a contra-indication for the use of the study medication, such as myocardial infarction within previous 6 months;

4. Use of electroconvulsive therapy (ECT) within 30 days prior to baseline, use of a MAO inhibitor within 14 days, use of fluoxetine within 21 days, use of any antidepressant drug (except those allowed during the study as concomitant treatment) within 3 days prior to baseline;

5. Alcohol or drug abuse within the last year, according to DSM IV criteria;

6. Presence of dementia, or a non-affective psychotic disorder, or a history of bipolar disorder (I and II), all according to DSM-IV criteria.