Pharmacopsychiatry 2015; 48(06): 205-210
DOI: 10.1055/s-0035-1559621
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Treating Depression with Botulinum Toxin: A Pooled Analysis of Randomized Controlled Trials

M. Magid*
1  Department of Psychiatry, University of Texas at Austin, Dell Medical School, Austin, TX, USA (MM)
,
E. Finzi*
2  Department of Psychiatry, George Washington School of Medicine, USA
,
T. H. C. Kruger*
3  Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany (THCK, SJ)
,
H. T. Robertson
4  Department of Analytics, Seton Family of Hospitals, Austin, TX, USA (HR)
,
B. H. Keeling
5  Department of Dermatology, University of Texas at Austin, Dell Medical School, Austin, TX, USA (BHK, JSR)
,
S. Jung
3  Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany (THCK, SJ)
8  Asklepios Clinic North – Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Germany (SJ, MAW)
,
J. S. Reichenberg
5  Department of Dermatology, University of Texas at Austin, Dell Medical School, Austin, TX, USA (BHK, JSR)
,
N. E. Rosenthal
6  Capital Clinical Research Associates, Rockville, MD, USA (NER)
7  Georgetown Medical School, Washington, DC, USA (NER)
,
M. A. Wollmer
8  Asklepios Clinic North – Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Germany (SJ, MAW)
9  Psychiatric Clinics of the University of Basel, Switzerland (MAW)
› Author Affiliations
Further Information

Publication History

received 26 May 2015
revised 15 July 2015

accepted 16 July 2015

Publication Date:
07 August 2015 (online)

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.

* Equal contribution.


Supporting Information