The paper offers a brief outline of the current state of geriatric psychiatry and psychopharmacology in Canada and partially in the USA. Major trends are described in clinical care, in organization and education, along with some basic historical comments. The important role of self-help groups is sketched. The contents of recent major scientific meetings illustrate the increasing emphasis in research in ageing, geriatric psychiatry and geriatric psychopharmacology. The developments are characterized by intimate connections between basic and applied research, and between clinical observations and experimental neurobiology. The analysis of developments in the current practice and research offers some insight into upcoming treatment strategies. The next decade in geriatric psychiatry will probably belong in particular to molecular biology, genetic, psycho-immunology and psychopharmacology.