A large cohort study from the UK has reached the surprising conclusion that tricyclics are the safest class of antidepressants in elderly people. The cohort comprised 60,746 primary care patients aged 65 and over (mean age 75) with a new diagnosis of depression recorded between January 1 1996 and December 31 2007. The cohort was followed up until December 31 2008. Comments Dr Phillip Bland,'Perhaps the most striking result from this study is that almost 90% of the patients were given antidepressants. For elderly patients with mild to moderate depression, the risks of antidepressant medication are likely to outweigh the benefits, and a psychosocial intervention may well be preferable.If we are to prescribe, I do not think there is sufficient evidence to justify prescribing very low dose tricyclics (