OBJECTIVE： To observe the efficacy and safety of Tianmeng oral liquid combined with paroxetine in the treatment of perimenopausal depression. METHODS： 85 patients with perimenopausal depression were randomly divided into control group （41 cases） and observation group （44 cases）. Control group received Paroxetine hydrochloride tablet 20 mg after the breakfast， once a day. Observation group was additionally given Tianmeng oral liquid 10 mL， once every morning and evening. They were treated for 8 weeks. The clinical efficacy， Kupperman score， HAMD score， brain-derived neurotrophic factor （BDNF） level before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： There were 1 patient lost in follow-up in control group， and 2 in observation group. There were no significant differences in the total effective rate and the incidence of adverse reactions in 2 groups （P＞0.05）. After treatment， Kupperman score and HAMD score in 2 groups were significantly lower than before， gradually reduced by time extension， Kupperman score after 8 weeks and HAMD score after 2 weeks in observation group were lower than control group， BDNF levels were significantly higher than before， gradually increased by time extension， and observation group was higher than control group， with statistical significances （P＜0.05 or P＜0.01）. CONCLUSIONS： The efficacy and safety of Tianmeng oral liquid combined with paroxetine in the treatment of perimenopausal depression are similar to paroxetine alone， while better than paroxetine alone in terms of improving symptoms and increasing BDNF.