The number of the elderly is rapidly growing and depression is known to affect this group of people aged 60 years and above quite seriously. Pharmacotherapy in this age presents many challenges. Both bupropion, and Nortriptyline, a TCA with mild anticholinergic effect have been prescribed for the old patients suffering from depressive symptoms.

In a randomized double-blind study with 8 weeks of follow-up we selected 52 elderly outpatients who had non psychotic major depressive disorder according to DSMIV criteria and they were allocated into two groups who received nortryiptiline (at a dose of up to 150 mg per day) and bupropion (at a dose of up to225mg per day). Cognitive state was assessed using the Mini-Mental State Examination.

The out patient clinics at the Ghaem and Avicenna Hospital, Faculty of Medicine of the University of Mashad.

Both treatments were efficacious, and there were no statistically significant differences between the two antidepressant classes with regard to efficacy (pvalue<0.05).

For elderly depressed patients who completed a 8 week treatment trial, both nortriptyline and bupropion exhibited good efficacy and few side effects. There was no significant difference between the two groups in their response rate or the severity of side effects resulting from medication.