Age represents an important factor influencing general principles of the pharmacotherapy and prophylaxis in late - life depression. Ageing may accentuate some clinical features and course of depression and may also increase the susceptibility to some side effects, e.g. extrapyramidal, cardiovascular or cognitive. Old patients and/or patients with serious physical disorders were often not included into clinical trials, so there are only limited data of EBM (Evidence Based Medicine) category. We present a recent review concerning clinical manifestation and pharmacotherapy of late-life depression. Summary of published studies is illustrated by our clinical data. Summary of evidence: depression developed in old age has a more complex aetiology, weight loss, anxiety and poor subjective memory or a dementia-like picture are common symptoms. Changes in cognitive or event-related brain potential (P300) have been well established as a sensitive measure of cognitive dysfunction. It can be used to differentiate cognitive disturbances related to depression from those caused by organic brain disease. Safety and tolerability are most important parameters for the choise of an antidepressant. Antidepressants with a selective mechanism of action are more safe in the terms of treatment-related intensity and profile of side effects. Citalopram and sertraline have well documented evidence of safety in the treatment of late - life depression with somatic comorbidity. Antidepressants with dual effect, e.g. venlafaxine and mirtazapine may also have effectivity and tolerability advantages in this indication.

        Key words: depression. old age, antidepressants, safety of pharmacotherapy.