Botox reduced depression, inhibited facial muscles expressed during sadness

NEW YORK — By treating the facial muscles responsible for emotion with onabotulinumtoxinA, doctors can alleviate depression symptoms in patients, according to data presented here at the American Psychiatric Association Annual Meeting.

Tillmann Kruger, MD, associate professor in the department of psychiatry, social psychiatry and psychotherapy, and M. Axel Wollmer, MD, a board-certified psychiatrist and psychotherapist, both at the Hannover Medical School in Hanover, Germany, conducted a randomized, double-blind, placebo-controlled study to determine whether botulinum toxin injected into the glabella region could improve depression.

Patients with treatment-resistant depression were randomly assigned to placebo (n=15) or onabotulinumtoxinA (n=15). The researchers compared the change in the Hamilton Depression Rating Scale (17-item version) after 6 weeks and baseline for the primary endpoint.

After 6 weeks, the average reduction in depression was 47.1% among patients assigned to Botox vs. 9.2% of those assigned to placebo (P=.002). This improvement was reported throughout 16 weeks of follow-up (P<.001), and researchers reported a larger effect size at the end of the study (d=1.80) and among females (d=2.41).

According to Kruger and Wollmer, two subsequent randomized controlled trials will replicate these findings.

“Facial expressions send feedback to the brain and reinforce emotions. Treating facial muscles with Botox interrupts this cycle,” Wollmer said in a presentation.

The moderator of this session, Jeffrey Borenstein, MD, CEO and President of the Brain & Behavior Research Foundation, said this research is crucial for patients resistant to current antidepressants. – by Abigail Sutton

For more information:

Kruger T. Abstract #8731. Presented at: American Psychiatric Association Annual Meeting; May 3-7, 2014; New York.

Disclosures: The researchers report no relevant financial disclosures.