Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with oral paroxetine in the treatment of older adult patients with severe depression and its effects on the scores of the Hamilton Rating Scale for Depression (HAMD), the Mini-Mental State Examination (MMSE), and Activities of Daily Living (ADL).Methods:A total of 192 older adult patients with severe depression who received treatment in Shaoxing 7 th People's Hospital from January 2018 to December 2019 were included in this study. They were randomly assigned to receive either oral paroxetine (control group, n = 96) or rTMS + oral paroxetine (observation group, n = 96). All patients received 1 month of treatment. Clinical efficacy was compared between the two groups. HAMD, MMSE, and ADL scores pre- and post-treatment and the incidence of adverse events during the treatment were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [96.88% (93/96) vs. 89.58% (86/96), χ2 = 4.04, P < 0.05]. HAMD scores post-treatment were significantly lower in the observation group than in the control group [(6.43 ± 2.33) points vs. (11.32 ± 2.02) points, t = 15.53, P < 0.05]. MMSE and ADL scores post-treatment in the observation group were (29.13 ± 3.01) points and (71.52 ± 5.32) points, respectively, which were significantly higher than those in the control group [(24.65 ± 2.79) points, (69.65 ± 5.17) points, t = 10.69, 2.47, P < 0.05]. There was no significant difference in the incidence of adverse events between the two groups ( P > 0.05). Conclusion:The combined therapy of rTMS and oral paroxetine is highly effective on severe depression in older adult patients. It can improve cognitive function and the activities of life living.

Objective:To observe the clinical effect of escitalopram in the treatment of treatment-resistant depression (TRD).Methods:A total of 90 patients with TRD who admitted to the Seventh People's Hospital of Shaoxing from January 2017 to January 2019 were divided into group A and group B by the random number table method, with 45 cases in each group.All subjects were given conventional treatment.On this basis, group A was treated with citalopram, and group B was treated with escitalopram.The clinical effect and adverse reactions were compared between the two groups.Results:The scores of Hamilton depression scale (HAMD) and clinical global impression (CGI) of group B after medication[(8.27±1.44)points and (2.82±0.74)points] were significantly lower than those of group A[(15.14±2.35)points and (4.87±1.33)points]( t=16.721, 9.035, all P<0.05). The total effective rate in group B after treatment (91.11%) was higher than that in group A (71.11%) (χ 2=5.874, P<0.05). The incidence of adverse reactions in group B (8.88%) was lower than that in group A (24.44%) (χ 2=3.920, P<0.05). Conclusion:Escitalopram is significantly effective in the treatment of TRD.It can effectively relieve the symptoms and reduce the incidence of adverse reactions.