Abstract:Objective To investigate the clinical efficacy of sertraline combined with aniracetam in adolescents with severe depression, and its effect on inflammatory factors and neurotrophic factors. Methods A total of 84 adolescents with depression treated in Hunan Brain Hospital from April 2019 to May 2020 were randomly divided into sertraline group (n=42, treated with sertraline alone) and combined group (n=42, treated with sertraline combined with aniracetam). The scores of Montreal Cognitive Assessment Scale (MoCA), quality of life scale (WHOQOL-BREF), symptom checklist 90 (SCL-90) and Hamilton Depression Scale (HAMD) were evaluated before and after treatment in two groups. The inflammatory reaction and neurotrophic factor related indicators were detected in two groups, and the complications and clinical efficacy of two groups were compared. Results After treatment, the scores of MOCA and WHOQOL-BREF increased, while the scores of SCL-90 and HAMD decreased in two groups（P<0.05）. The scores of MOCA and WHOQOL-BREF in combined group were higher than those in sertraline group, and the scores of SCL-90 and HAMD were lower than those in sertraline group (P<0.01). After treatment, the levels of 5-hydroxytryptamine(5-HT) and glial cell line-derived neurotrophic factor(GDNF) increased, while the levels of IL-6, IL-1β and TNF-α were decreased (P<0.05). The levels of 5-HT and GDNF in combined group were higher than those in sertraline group, the levels of IL-6, IL-1β and TNF-α were lower than those in sertraline group (P<0.01). The effective rate of combined group was higher than that of sertraline group (92.86% vs 71.43%, P<0.05). Conclusion The application of sertraline combined with aniracetam in the treatment of adolescents with severe depression can relieve their anxiety and depression, improve their quality of life, alleviate inflammatory reactions, and have a good clinical effect.