Changes from 1985 to 1999 in diagnosis of depression and prescription of antidepressant medications during visits by elderly patients to primary care physicians, psychiatrists, and other specialists were examined. Using nationally representative surveys of office-based practices, estimates of the proportion of office visits by elderly patients during which a physician diagnosed depression or prescribed an antidepressant medication were obtained. Between 1985 and 1993-1994, a significant increase in the rate of depression diagnosis was seen, but no change was observed between 1993-1994 and 1998-1999. Rates of prescribing of antidepressants more than doubled between 1985 and 1998-1999. The majority of depression visits and visits where an antidepressant was prescribed were to primary care physicians in all time periods examined. Primary care depression treatment initiatives should place greater emphasis on elderly patients.