commonly used as second-line agents when remission is not obtained with SSRIs. In small studies, venlafaxine did not show greater efficacy than placebo,but a larger, placebocontrolled trial of duloxetine showed significant improvements in late-life depression (response rate, 37% vs. 19%; remission rate, 27% vs. 15%). As observed in trials involving younger adults, randomized trials involving older adults have not shown significant differences between the benefits of SSRIs and those of SNRIs, although adverse effects may be more frequent with SNRIs.