腦中風是當今危害台灣老年人健康的主要疾病之一，中風後患者易併發多種神經精神症狀，而抑鬱症是腦中風後最常見的精神症狀併發症，中風後抑鬱症會影響患者回復的速度、恢復的結果、而且嚴重影響患者的生活質量；同時它也會增加病患住院日數以及醫療成本。因此，中風後抑鬱症是一個重要的公共衛生議題，也是腦中風研究經常關注的焦點。在臨床實務工作中，只有少數的中風後抑鬱症病人被確立診斷，而且只有少數的患者及時得到治療，本文探討文獻中有關中風後抑鬱症的概念；觀察和分析腦中風後抑鬱狀態的發病率情況及其相關影響因素；討論目前臨床常用的藥物和非藥物治療。常見藥物治療包括抗憂鬱劑中的血洛特寧選擇回收抑制劑、三環抗鬱劑及中藥的心脾解鬱湯等。常見的非藥物治療包括電氣昏迷療法、心理分析及衛教諮商。治療中風後抑鬱症應考慮先使用藥物治療來改善抑鬱狀態。本文強調應早期發現中風後併發抑鬱狀態的患者並能及早治療，更建議醫護同仁應進一步研究如何預防及減少中風後抑鬱症的發生。中風後抑鬱症的研究應得到臨床的重視。

Stroke is a major health problem in the elderly population in Taiwan. Patients who have had strokes are at significant risk for various neuropsychiatric illnesses. The most common and important neuropsychiatric illnesses is poststroke depression (PSD). PSD affects the speed of recovery, functional outcome, and has an important impact on the quality of life of patients with stroke. PSD also increase institutional length of stays and health care cost. Therefore, PSD is an important public health issue and has received the most attention in stroke research. In clinical practice, only minority of PSD patients are diagnosed and even fewer are treated. This paper reviews the current literature on PSD and offers an integrated approach to PSD concepts, prevalence of PSD, associated factors, and practical pharmacologic and nonpharmacologic intervention for PSD. Effective pharmacologic treatment includes anti-depressants: SSRI, TCA; Chinese pharmacy (tonic to the heart and spleen & smooth depression decoction) etc. Nonpharmacologic treatment includes ECT, Psychotherapy, and educational counselling. Drug therapy is the first choice intervention for PSD. This paper highlights the importance of early recognition and emphasis on clinical support and therapy in the care of patients with depression following stroke. Research to prevent and reduce depression after stroke might be a worthy project for the future.