Medications vary from patient to patient depending on the patient’s diagnosis and concurrent medical condition. Patients who are resistant to pharmacological therapy and are recommended ECT may benefit from a different class of drugs during the maintenance phase after electroconvulsive therapy. In geriatric patients with major depressive disorders, nortriptyline combined with acute and continuation electroconvulsive therapy has resulted to be safe and effected in reducing post-acute ECT relapse. Patients with depressive disorders who were resistant to drug therapy before ECT may benefit from the same class of drugs during maintenance ECT. In any trial of antidepressants, the appropriate dose and duration of the medication should be considered when creating the maintenance plan.