OBJECTIVE To study efficacy and safety of pirazidol administration in depressive patients with ischemic heart disease (IHD). METHODS Pirazidol was given in a dose 0.15-0.3 g/day for 4 weeks to 30 IHD patients aged 21-65 years. 21 of them had nosogenic depression, 9 patients had dysthymia. The efficacy of the antidepressive action was assessed by the Hamilton scale. RESULTS The trend to a decrease in Hamilton scale scores was manifest by the end of the treatment week 2. To the end of the study the overall score median lowered from 17 to 9, most of the patients had the score sum under 11. Side effects were insignificant. In pirazidol combination with beta-blockers, blockers of calcium channels, antiaggregant, diuretic drugs, nitrates and other cardio- and angiotropic drugs unfavorable interactions were not registered. CONCLUSIONS Pirazidol can be effectively used in the treatment of psychosomatic disorders in patients with cardiovascular diseases.