Depression is very frequent in old people, according to epidemiological studies its occurs in 10-15 %. In old people living in medical or social institutions it is even more frequent. In old age also more severe forms of depression are encountered more frequently, and resistance and a chronic course are more frequent. Despite this, depression in old people is often inadequately diagnosed and frequently not adequately treated. The new generation of antidepressants (e.g. SSRI) have eliminated the disadvantages of classical antidepressants such as the adverse spectrum of undesirable effects, suicidal risk etc. As regards effectiveness they have not contributed much. The subsequent generation of antidepressants with dual action raises new hopes. The authors present hitherto published work on milnacipran, venlafaxin and mitrazapin and draw attention to their possible use in gerontopsychiatry. Antidepressants with a dual effect have an effectivity at least comparable with classical ones, they have however a more rapid onset of action as well as a favourable spectrum of undesirable effects . It seems that they exert a favourable effect also on inhibited and anxiety depressions.

        Key words: depression in the aged, dual action of antidepressants, milnacipran, venlafaxin, mirtazapin.