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Facing depression with botulinum toxin: a randomized controlled trial.

M Axel Wollmer¹, Claas de Boer, Nadeem Kalak

¹Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str 27, 4012 Basel, Switzerland. axel.wollmer@unibas.ch

Journal of Psychiatric Research

|February 28, 2012

Summary

This summary is machine-generated.

Botulinum toxin injections targeting glabellar frown lines significantly improved depression symptoms in patients unresponsive to other treatments. This study suggests facial muscle activity influences mood regulation, offering a novel therapeutic avenue.

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Area of Science:

Neuroscience
Psychiatry
Dermatology

Background:

Previous observations suggest positive mood effects from botulinum toxin treatment for glabellar frown lines.
Open case series indicated depression remission or improvement following such treatment.

Purpose of the Study:

To assess botulinum toxin (onabotulinumtoxinA) injection in the glabellar region as an adjunctive treatment for major depression using a randomized double-blind placebo-controlled trial.

Main Methods:

Thirty patients with major depression were randomized into two groups: verum (onabotulinumtoxinA, n=15) or placebo (saline, n=15).
The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) six weeks post-treatment compared to baseline.

Main Results:

The verum group showed a significant improvement in depressive symptoms compared to the placebo group throughout the 16-week follow-up (p < 0.001).
Six weeks after treatment, HDRS scores decreased by 47.1% in the onabotulinumtoxinA group versus 9.2% in the placebo group (p = 0.002).
Significant improvements were also noted on the Beck Depression Inventory and Clinical Global Impressions Scale, with large effect sizes (d=1.80 at study end).

Conclusions:

A single glabellar treatment with botulinum toxin can provide rapid and sustained depression alleviation in patients with insufficient response to prior medications.
The findings support the hypothesis that facial musculature not only expresses but also regulates mood states.