Journal of International Psychiatry

[Abstract] Objective: To observe the influence of paroxetine combined with high frequency repetitive transcranial magnetic stimulation (rTMS) on cognitive functions, myelin basic protein (MBP) and neuron specific enzym (NSE) of elderly patients with treatment-refractory depression (TRD). Methods: 102 cases of elderly patients with TRD treated in our hospital were selected as the study objects, and were divided into observation group and control group according to random and equal principle. The control group were treated with paroxetine, and the observation group were combined with rTMS on the basis of the control group. Cognitive function, mental status, MBP and NSE concentrations, and incidence of adverse reactions were observed in the two groups. Results: Cognitive function scores after treatment of two and four weeks were significantly lower than those before treatment in the two groups (P < 0.05), which of the observation group were significantly lower than those of the control group (P < 0.05). Scores of HAMA and HAMD after treatment of four weeks were significantly lower than those before treatment in the two groups (P < 0.05), which of the observation group were significantly lower than those of the control group (P < 0.05). Levels of MBP and NSE after treatment of four weeks were significantly lower than those before treatment in the two groups (P < 0.05), which of the observation group were significantly lower than those of the control group (P < 0.05). The incidence of adverse reactions was 9.80% in the observation group, slightly lower than that of 11.76% in the control group (P > 0.05). Conclusion: Paroxetine combined with rTMS can effectively improve cognitive function of elderly patients with TRD, relieve anxiety and depression, and reduce the concentration of MBP and NSE.

[Keywords] Paroxetine; High frequency repetitive transcranial magnetic stimulation; Refractory depression; Cognitive function; Leukoaraiosis