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目的：探讨艾司西酞普兰与舍曲林治疗老年脑卒中后抑郁患者的临床疗效和安全性。方法将80例老年脑卒中后抑郁患者随机分为两组，均予以神经内科常规治疗及康复治疗，在此基础上研究组口服艾司西酞普兰治疗，对照组口服舍曲林治疗，观察8周。治疗前后采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果研究组治疗第1周末汉密顿抑郁量表总分较对照组下降更显著（ P＜0．01），治疗第8周末研究组显效率80．0％、有效率92．5％，对照组分别为70．0％、90．0％，两组比较差异均无显著性（ P＞0．05）。两组不良反应较轻微，但研究组口干、腹泻不良反应发生率显著低于对照组（P＜0．01）。结论艾司西酞普兰治疗老年脑卒中后抑郁的疗效显著，与舍曲林相当，但艾司西酞普兰起效更快，安全性更高，更适合老年脑卒中后抑郁患者。“,”Objective To explore the efficacy and safety of escitalopram and sertraline in the treatment of senile post‐stroke depression (PSD) .Methods Eighty senile PSD patients were randomly divided into two groups ,both received neuro‐medical routine treatment and convalescent care ,on this basis research group took orally escitalopram and control group did sertraline for 8 week .Efficacies were assessed with the Hamilton Depression Scale (HAMD) before and after treatment and adverse reactions with the Treat‐ment Emergent Symptom Scale (TESS) .Results At the end of the 1st week the HAMD total score low‐ered more significantly in research than in control group (P0 .05) .Adverse reactions of both groups were mild , but dry mouth and diarrhea incidence were significantly lower in research than in control group ( P<0 .01) .Conclusion Escitalopram has an evident effect equivalent to sertraline in the treatment of PSD , but the former takes effect more rapidly ,has higher safety ,and is more suitable for senile PSD patients .