Objective To explore the clinical effect of escitalopram combined with xingnaojing in post-stroke depression (PSD).Methods Seventy-four cases with PSD were divided into treatment group (38 cases) and control group (36 cases) by random digits table,control group was given escitalopram,treatment group was given escitalopram and xingnaojing.Hamilton depression scale (HAMD),mental state examination (MMSE),memory quotient (MQ) and activities of daily life (ADL) score,clinical curative effect and adverse reaction were compared between 2 groups.Results The HAMD,MMSE,MQ,ADL score after treatment in 2 groups were significantly better than those before treatment [control group:(14.26 ± 2.61)scores vs.(29.73 ± 5.17) scores,(23.26 ± 3.75) scores vs.(21.24 ± 3.38) scores,(86.53 ± 6.49) scores vs.(82.35 ± 5.42) scores,(61.37 ± 3.72) scores vs.(45.32 ±4.48) scores;treatment group:(10.31 ± 2.08)scores vs.(29.57 ± 6.09) scores,(27.83 ± 4.31) scores vs.(21.63 ± 3.82) scores,(95.63 ± 6.41) scores vs.(82.30 ± 7.48) scores,(69.15 ± 6.39) scores vs.(45.27 ± 4.28) scores,P ＜ 0.05].The HAMD,MMSE,MQ,ADL score after treatment in treatment group were significantly better than those in control group (P ＜0.05).The total effective rate in treatment group was significantly higher than that in control group [97.4％(37/38) vs.86.1％(31/36),P ＜ 0.05].There was no significant difference in rate of adverse reaction between 2 groups (P＞ 0.05).Conclusion Escitalopram combined with xingnaojing in PSD is effective and safe,and worth further clinical application promotion.

Objective To investigate the effect of agomelatine on the clinical efficacy in elderly patients with acute cerebral infarction(ACI)and comorbid anxiety-depression disorders by regu-lating serum neurotransmitters and nerve cytokines.Methods A total of 160 elderly ACI patients with anxiety and depression symptoms admitted in Pingxiang Second People's Hospital from June 2020 to December 2023 were enrolled in this study.All of them received thrombolysis or interven-tional therapy,and then were randomly divided into control and observation groups,with 80 patients in each group.The control group received conventional psychological intervention,while the observation group was given additional oral administration of agomelatine.Cognitive function,neurological function,neurotransmitters and neuronal cytokines,anxiety and depression scores,sleep quality,quality of life,daily activity ability and adverse reactions were compared between the two groups.Results After intervention,Mini Mental State Examination(MMSE)scores,levels of neuropeptide Y(NPY),5-hydroxytryptamine(5-HT),norepinephrine(NE),dopamine and brain-derived neurotrophic factor(BDNF),36-item Brief Health Questionnaire(SF-36)score,and Bar-thel index scale score were significantly higher in both 2 groups when compared with above indicators before the intervention(P＜0.01).And the MMSE score,NPY,5-HT,NE,dopamine and BDNF levels,SF-36 score and Barthel index scale score were obviously higher in the observa-tion group than the control group(P＜0.01).Both groups obtained notably lower NIHSS score,S100 calcium binding protein B(S100B)and myelin basic protein(MBP)levels,Hamilton Anxiety Rating Scale(HAMA)score,and Hamilton Depression Rating Scale 17(H AMD-17)score and Pittsburgh Sleep Quality Index(PSQI)score after intervention(P＜0.01).And the NIHSS score,S100B and MBP levels,HAMA score,HAMD-17 score,and PSQI score were statistically lower in the observation group than the control group(P＜0.01).During the treatment process,no signifi-cant difference was observed in the incidence of total adverse reactions between the two groups(3.75％vs 6.25％,x2=0.526,P=0.468).Conclusion When agomelatine tablets are indicated for ACI patients with concomitant anxiety-depression disorders,they can effectively rehabilitate cog-nitive function,enhance neurological function,improve sleep quality and quality of life,optimize activities of daily living,eliminate negative emotions,and correct the expression of neurotransmit-ters and neurotrophic factors.