Objective To evaluate the efficacy and safety for duloxetine alone and combined with repetitive transcranial magnetic stimulation in the treatment of generalized anxiety disorder (GAD).Methods 60 GAD patients were randomly divided into two groups using number table.30 cases in the control group were given duloxetine treat-ment,and 30 patients in the observation group were given duloxetine combined with repetitive transcranial magnetic stimulation treatment.The clinical efficacy and adverse reactions were compared.Results The total effective rate of the control group was 70.0 %,which of the observation group was 76.7%,the difference between the two groups was not significant (χ2 =2.44,P >0.05).When treatment 1,2,4,6 weeks,Hamilton Anxiety Scale (HAMA)score were significantly lower than before treatment(t =6.23,7.44,7.73,7.78,8.42,8.53,9.60,9.81,all P <0.05).1 week after treatment,HAMA score of the observation group was significantly lower than the control group (t =6.77,P <0.05).2,4,6 weeks after treatment,HAMA score between the two groups had no significant differences (t =2.20, 1.87,2.41,all P >0.05).The incidence rate of adverse reactions of the observation group (23.3%)was significantly lower than the control group (36.7%),the difference was statistically significant (χ2 =7.44,P <0.05 ). Conclusion The efficacy of duloxetine alone and combined with repetitive transcranial magnetic stimulation in treat-ment of GAD is fairly,but combination therapy has faster onset,better security,it is possible to shorten the time of onset of drug and improve patients'treatment compliance,which is more suitable for clinical application.