Abstract:Objective?To investigate the effect of trazodone, mirtazapine and agomelatine on liver function of middle-aged and elderly patients with chronic insomnia and depression, and to provide clinical reference. Methods?A total of 109 patients with chronic insomnia and depression admitted to Beijing Hospital of Integrated Traditional Chinese and Western Medicine from January 2010 to December 2019 were retrospectively analyzed, and they were divided into trazodone group (40 cases), mirtazapine group (37 cases) and agomelatine group (32 cases) according to different drugs. The changes of alanine transaminase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in 3 groups were compared after treatment, and the intervention methods and outcomes were followed up. Results?Mirtazapine group of patients with severe abnormal liver function much higher than the trazodone group, agomelatine group (P < 0.05), the incidence of abnormal liver function in agomelatin group was significantly higher than that in trazodone group and mirtazapine group (P < 0.05), three groups of patients with abnormal liver function index changes, there was no statistically significant difference (P >0.05). The proportion of abnormal liver function induced by agomelatine was higher at low dose. The proportion of abnormal liver function induced by mirtazapine was significantly increased at high dose (P<0.05). Conclusion?Antidepressants have certain effects on the liver function of middle-aged and elderly people, so the liver function should be monitored regularly to ensure the safety of drug use.