Unfortunately, the rigor of prescribing tricyclic antidepressants in research studies usually does not carry over to practice in the community. There is abundant evidence that in primary care settings, where most antidepressants are used, tricyclic antidepressants are seldom prescribed at doses that are effective for the treatment of major depression (2, 3). Moreover, the most frequently prescribed tricyclic antidepressants are tertiary amine drugs (3, 4), which are probably least likely to be tolerated by elderly patients (5). In contrast, the vast majority of patients treated with SSRIs receive an effective dose (2, 3). Also, in clinical practice settings, discontinuation rates appear to be lower for SSRIs than for tricyclic antidepressants (4, 6). Thus, there is good reason to believe that a prescription for an SSRI is more likely to result in adequate treatment of depression in elderly patients than is a prescription for a tricyclic antidepressant.