Objective. To evaluate the efficacy and tolerability of rac-hopantenic acid (pantogam activ) in patients with mixed anxiety-depressive disorder and anxiety-depressive disorder with chronic cerebral ischemia. Material and methods. A total of 50 patients were examined (30 patients in the main group, 20 patients in the control one). All patients received standard therapy with SSRI antidepressants. Rac-hopantenic acid at a daily dose of 1200 mg was included in the complex therapy of patients of the main group. Duration of the therapy with rac-hopantenic acid was 21 days. Psychopathological, psychometric and detailed somatic examinations were performed. Results. In the main group, the combination of pantogam activ and antidepressants promoted distinct balanced nootropic, antidepressant and anxiolytic effects, as well as the improvement of health outcomes. The reduced total number of adverse events (less frequent drowsiness and headaches) was noted as well. Conclusion. The rapid and reliable reduction of anxiety, depression and cognitive impairment during concomitant therapy with antidepressants and pantogam activ was identified.