Objective: To evaluate the differences in the clinical effect and the safety in the treatment of post-stroke anxiety disorder (PSAD) between electroacupuncture (EA) and paroxetine on the base of the heart-brain theory.Methods: A total of 70 patients of PSAD were randomized into an EA group and a medication group,35 cases in each one.In the EA group,four acupoints were selected and divided into two pairs.In the Pair A,there were Bǎihuì(百会 GV20) and Fēngfǔ (风府 GV16).In the Pair B,there were Xīnshū (心俞 BL15) and Shénmén(神门 HT7).After acupuncture,the electroacupuncture apparatus was applied.The duration of needle retention was 20 min.EA was given three times a week,totally for 4 weeks.In the medication group,paroxetine tablets were administered orally,10 mg daily in the first 4 days and 20 mg afterwards,totally for 4 weeks.Before and after treatment,as well as in the follow-up period,Hamilton anxiety scale (HAMA),Barthel index (BI) for daily life ability,and clinical global impression (CGI) were observed and the clinical therapeutic effect was evaluated separately.Results: A total of 3 cases were dropped-out in the medication group.Finally,35 cases in the EA group and 32 cases in the medication group were included in the analysis.Compared with the scores before treatment,the scores of HAMA and CGI-SI (severity of illness) were lower and the scores of BI were higher after treatment and during the follow-up in either the EA group or the medication group (all P ＜ 0.05).Compared with the scores after treatment,the differences were not significant in HAMA and CGI-SI scores during the follow-up in either the EA group or the medication group (all P ＞ 0.05).Compared with the medication group,BI score in the EA group was higher in the follow-up,indicating the statistical significance (P ＜ 0.05).After treatment,CGI-SI score was different statistically between the EA group and the medication group (P ＜ 0.05).There were 5 cases with adverse reactions in the EA group and 9 cases in the medication group.Conclusions: The therapeutic effect of electroacupuncture on the base of heart-brain theory is similar to the oral administration of paroxetine in the treatment of post-stroke anxiety disorder.This therapy relieves anxious emotions,promotes the recovery of limb function and has less adverse reactions in the patients.