The purpose of this study was to compare the effects of amitriptyline and ECT in the treatment of depression. Thirty patients were assigned randomly to 4 treatment groups: amitriptyline, ECT, placebo and simulated ECT. Global improvement ratings, the Depression Rating Scale, the Ward Observation Inventory, the M.M.P.I., the Wechsler-Bellevue Intelligence Scale and the Bender-Gestalt test were used in evaluating the response to treatment. Amitriptyline and ECT were both more effective than control procedures. There was no appreciable difference after one month of treatment between the therapeutic effects of amitriptyline and ECT.