Treating depression with botulinum toxin: a pooled analysis of randomized controlled trials

Pharmacopsychiatry. 2015 Sep;48(6):205-10. doi: 10.1055/s-0035-1559621. Epub 2015 Aug 7.

Abstract

Introduction: Botulinum toxin A (BTA) injection into the glabellar region is currently being studied as a treatment for major depressive disorder (MDD). Here we explore efficacy data of this novel approach in a pooled analysis.

Methods: A literature search revealed 3 RCTs on this topic. Individual patient data and clinical end points shared by these 3 trials were pooled and analyzed as one study (n=134) using multiple regression models with random effects.

Results: In the pooled sample, the BTA (n=59) and the placebo group (n=75) did not differ in the baseline variables. Efficacy outcomes revealed BTA superiority over placebo: Improvement in the Hamilton Depression Rating Scale or Montgomery-Asberg Depression Rating Scale 6 weeks after baseline was 45.7% for BTA vs. 14.6% for placebo (p<0.0001), corresponding to a BTA response rate of 54.2% (vs. 10.7%) and a BTA remission rate of 30.5% (vs. 6.7%).

Discussion: Equalling the status of a meta-analysis, this study increases evidence that a single treatment of BTA into the glabellar region can reduce symptoms of MDD. Further studies are needed to better understand how BTA exerts its mood-lifting effect.

Publication types

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

MeSH terms

  • Acetylcholine Release Inhibitors / administration & dosage
  • Acetylcholine Release Inhibitors / therapeutic use
  • Botulinum Toxins, Type A / administration & dosage
  • Botulinum Toxins, Type A / therapeutic use*
  • Depressive Disorder, Major / drug therapy*
  • Female
  • Humans
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Acetylcholine Release Inhibitors
  • Botulinum Toxins, Type A