Objective To study the efficacy and safety of escitalopram and sertraline in the treatment of senile depression. Methods Sixty-eight senile depression patients were randomly assigned to escitalopram group and sertraline group for 4 weeks.Clinical effectiveness were evaluated by HAMD,and adverse rections were assessed with TESS. Results The response rate were 82.4% in escitalopram group and 79.4% in sertraline group,with no singificant difference between two groups(P0.05).At the end of 1 week treatment,there was significant difference in the scores of HAMD between two groups(P0.05).The adverse reactions were 38.2% in escitalopram group and 44.1% in sertraline group,and there was no significant difference between two groups(P0.05). Conclusions The efficacy of escitalopram in treating senile depression is similar to those of sertraline.Escitalopram takes effect more quickly than sertraline.