This research study is to evaluate the safety and usefulness of venlafaxine-XR in the treatment of major depression in the elderly.

The primary objective of this pilot study is to evaluate the safety of venlafaxine extended release formulation (XR) in the treatment of geriatric non-psychotic depression. This pilot study's specific aims are to assess the safety of venlafaxine XR in the geriatric population, to estimate the response rate of older depressed subjects treated under open conditions and to evaluate pharmacokinetic characteristics that may impact on safety and outcome.

Inclusion Criteria:

• men and women of all races who are 60 years old or older;
• a DSM-IV diagnosis of major depressive episode without psychotic features;
• 17-item Ham-D score of >15 for potential subjects who have not received any antidepressant treatment during this illness episode or HAM-D > 11 for potential subjects who have received treatment with an antidepressant (other than venlafaxine-XR) during this illness episode;
• a MMSE score of >15.

Exclusion Criteria:

• history of meeting DSM-IV criteria for mania, schizophrenia or other psychotic disorder;
• history of substance abuse or dependence, including alcohol, within the last three months;
• current hyponatremia (as defined as a serum sodium level < 130 meq/l);
• untreated or uncontrolled hypertension;
• a history of being unable to tolerate venlafaxine-XR or venlafaxine immediate release formulation;
• history of receiving venlafaxine-XR or venlafaxine immediate release formulation of 6 or more weeks at 300mg/d during index depressive episode; (7) EKG revealing QTc > 480 msec;
• myocardial infarction, unstable angina, palpitation or cardiogenic syncope within 3 months prior to entering this study;
• the presence of active suicidal ideation with intent.