〔Abstract〕 Objective To investigate the clinical effect of anti-epilepsy decoction combined with citalopram in the treatment of epilepsy accompanied by anxiety and depression. Methods A total of 90 patients with epilepsy combined with anxiety and depression from Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from April 2021 to June 2021 were selected and randomly divided into observation group, control group 1 and control group 2, with 30 cases in each group. All patients in the three groups were treated with conventional antiepileptic drugs, patients in the control group 1 were treated with citalopram, patients in the control group 2 were treated with anti-epileptic decoction, patients in the observation group were treated with anti-epileptic decoction and citalopram, and the therapeutic effects of the three groups were compared. Results After treatment, the scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) in the three groups were lower than those before treatment, and the HAMA and HAMD scores of patients in the observation group were lower than those in the control group 1 and the control group 2, with statistical significance (P < 0.05). In the observation group, 2 patients had gastrointestinal symptoms such as nausea and diarrhea at the beginning of taking the drug, which did not affect the treatment. Conclusion The effect of anti-epilepsy decoction combined with citalopram based on phlegm-stasis and wind-three causes is better than that of Western medicine alone or anti-epilepsy decoction alone.