Botulinum toxin for the management of depression: An updated review of the evidence and meta-analysis

Jara Schulze; Insa Neumann; Michelle Magid; Eric Finzi; Christopher Sinke; M Axel Wollmer; Tillmann H C Krüger

doi:10.1016/j.jpsychires.2021.01.016

Botulinum toxin for the management of depression: An updated review of the evidence and meta-analysis

J Psychiatr Res. 2021 Mar:135:332-340. doi: 10.1016/j.jpsychires.2021.01.016. Epub 2021 Jan 21.

Authors

Jara Schulze¹, Insa Neumann², Michelle Magid³, Eric Finzi⁴, Christopher Sinke¹, M Axel Wollmer², Tillmann H C Krüger⁵

Affiliations

¹ Hannover Medical School, Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
² Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Langenhorner Chaussee 560, 22419, Hamburg, Germany.
³ Department of Psychiatry, Dell Medical School, University of Texas at Austin, 1601 Trinity St., Bldg. B, Stop Z0600, Austin, TX, 78712, USA.
⁴ Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine, 2120 L Street, NW, Suite 600, Washington, DC, 20037, USA.
⁵ Hannover Medical School, Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany; Center for Systems Neuroscience, Bünteweg 2, 30559 Hannover, Germany. Electronic address: krueger.tillmann@mh-hannover.de.

PMID: 33578275
DOI: 10.1016/j.jpsychires.2021.01.016

Abstract

Botulinum toxin (BTX) treatment of glabellar frown lines is one of the most common procedures in aesthetic medicine. In addition to its cosmetic effect, the neurotoxin has been shown to have a positive influence on mood and affect. Several randomized clinical trials (RCTs) have examined the effect of botulinum toxin on the treatment of depression. Combining the results of the five RCTs in a random effects meta-analysis revealed that patients treated with BTX showed a more intense improvement of depressive symptoms in comparison to subjects that received placebo injections (d = 0.98). Despite methodological limitations, the results of this study emphasize the effectiveness of BTX in the treatment of depression and therefore pave the way for its use in the field of psychiatry.

Keywords: Botulinum Toxin; Depression; Meta-Analysis; Updated Evidence.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Affect
Botulinum Toxins, Type A*
Depression / drug therapy
Humans
Neuromuscular Agents*
Skin Aging*
Treatment Outcome

Substances

Neuromuscular Agents
Botulinum Toxins, Type A