Botulinum toxin in the depression treatment: an updated review of scientific evidence
DOI:
https://doi.org/10.59255/mmed.2024.95Keywords:
Depression, Botulinum Toxin, Facial ExpressionsAbstract
Depression is a condition affecting almost three hundred (300) million people throughout the world and is considered the leading disability cause. There is a demand for new approaches to treat depression with minimal side effects to improve treatment adherence and lower drug interactions. Several studies have shown that a single intramuscular injection of botulinum toxin into the glabellar region can be an effective and well-tolerated treatment for depression. This study aims to conduct a literature review on the botulinum toxin use for depression treatments. A search in PubMed, Web of Science, Scopus, and Lilacs databases was conducted, comprising at most a period of the last twenty (20) years. Keywords are: ‘botulinum toxin’, ‘depression’, ‘toxin botulinum, and depression’. Sixteen (16) relevant clinical studies were selected, of which other references were sorted out. Finally, a series of randomized clinical trials and meta-analyses have shown that botulinum toxin injections into the glabella and elsewhere in the body may reduce mild to moderate depression symptoms. Based on its aesthetic indication, botulinum toxin can be used in clinical management to treat depression. botulinum toxin has proved to be beneficial for patients who are unable to progress well or who have experienced side effects with more commonly used antidepressant treatments. The most accepted explanation is that botulinum toxin treatment has proprioceptive feedback from the face as a positive effect on depressive mood disorder. However, actual mechanisms of action are still unknown and are the subject of ongoing research.
Downloads
References
Wollmer MA, Magid M, Kruger THC, Finzi E. The Use of Botulinum Toxin for Treatment of Depression. Handb Exp Pharmacol. 2021;(263):279.
Cleare A, Pariante CM, Young AH, Anderson IM, Christmas D, Cowen PJ, et al. Evidence-based guide- lines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol. 2015; (29): 459-525.
Dressler D, Johnson EA. Botulinum toxin therapy: past, present and future developments. Journal of Neural Transmission. 2022; (129):829–833.
Finzi E, Wasserman E. Treatment of Depression with Botulinum Toxin A: A Case Series, Dermatol Surg. 2006;(32):645–650.
Coles NA, Larsen JT, Kuribayashi J, Kuelz, A. Does blocking facial feedback via botulinum toxin injections decreasedepression? A critical review and meta- analysis. Emot Rev. 201; (11): 294–309.
Parsaik AK, Mascarenhas SS, Hashmi A, Procop JL, John V, Okusaga O, et al. Role of botulinum toxin in depression. J Psychiatr Pract. 2016; (22):99-110.
Schlessinger J, Gilbert E, Cohen JL, Kaufman J. New Uses of AbobotulinumtoxinA. Aesthetics. Aesthetic Surgery Journal. 2017; 37(Suppl1): S45–S58.
Satriyasa BK. Botulinum toxin (Botox): A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. 2019; (12): 223–228.
Monheit GD, Pickett A. AbobotulinumtoxinA: a 25-year his- tory. Aesthet Surg. 2017;(37): S4–S11.
Heckmann M, Teichmann B, Schröder U, Sprengelmeyer R, Ceballos-Baumann AO. Pharmacologic denervation of frown muscles enhances baseline expression of happiness and decreases baseline expression of anger, sadness, and fear. J Am Acad Dermatol. 2003, (49):213–216.
Ascher B, Zakine B, Kestemont P. A multicenter, random- ized, double-blind, placebo-controlled study ofefficacy and safety of 3 doses of botulinum toxin A in the treatment of glabellar lines. J Am Acad Dermatol. 2004; (51): 223–233.
Hennenlotter A, Dresel C, Castrop F, Ceballo-Bauman AO, Wohlschläger AM, Haslinger B. The link between facial feedback and neural activity within central circuitries of emotion-new insights from botulinum toxininduced dener- vation of frown muscles. Cereb Cortex. 2009; (19):537–542.
Kim MJ, Neta M, Davis FC, Ruberry EJ, Dinescu D, Heatherton TF, et al. Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design. Biol Mood Anxiety Disord. 2014; (4):11.
Erbguth, F. From poison to remedy: The chequered history of botulinum toxin. J. Neural Transm. 2008; (115): 559–565.
Segura-Aguilar J, Tizabi Y. Botulinum Neurotoxin, an Example of Successful Translational Research. Clin. Pharmacol. Transl. Med. 2018;(2): 125.
Dolly J, Aoki K. The structure and mode of action of different botulinum toxins. Eur J Neurol. 2006;13): 1–9.
Lacy DB, Tepp W, Cohen AC, DasGupta BR, Stevens RC. Crystal structure of botulinumneurotoxin type A and implications for toxicity. Nat. Struct. Biol. 1998; (5): 898–902.
Kao I, Drachman DB, Price DL. Botulinum toxin: Mechanism of presynaptic blockade. Science. 1976; (193): 1256–1258.
Jabbari, B. Botulinum Toxin Treatment in Clinical Medicine. Switzerland: Springer: Cham; 2017.
Wollmer MA, de Boer C, Kalak N, Beck J, Götz T, ScHmidt T, et al. Facing depression with botulinum toxin: a randomized controlledtrial. J Psychiatr Res. 2012; (46):574–581.
Finzi E, Rosenthal NE. Treatment of depression with onabotulinumtoxinA: a randomized, double-blind, placebo controlled trial. J Psychiatr Res. 2014; (52):1– 6.
Magid M, Finzi E, Kruger TH, Robertson HT, Keeling BH, Jung S, et al. Treating depression with botulinum toxin: a pooled analysis of randomized controlled trials. Pharmacopsychiatry. 2015; (48):205–210.
Zamanian A, Ghanbari Jolfaei A, Mehran G, Azizian Z. Efficacy of Botox versus Placebo forTreatment of Patients with Major Depression. Iran. J. Public Health 2017; (46): 982–984.
Brin MF, Durgam S, Lum, A, James L, Liu J, Thase ME, Szegedi A. OnabotulinumtoxinA for the treatment of major depressive disorder: A phase 2 randomized, double-blind, placebo-controlled trial in adult females. Int. Clin. Psychopharmacol. 2020; (35): 19–28.
Zhang Q, Wu W, Fan Y, Li Y, Liu J, Xu Y, et al. The safety and efficacy of botulinum toxin A on the treatment of depression. Brain Behav. 2021(11):2333.
Schulze J, Neumann I, Magid M, Finzi E, Sinke C, Wollmer M.A, et al. Botulinum toxin for the management of depression: An updated review of the evidence and meta-analysis. J. Psychiatr.Res. 2021;(135): 332–340.
Crowley JS, Silverstein ML, Reghunathan M, Gosman AA. Glabellar Botulinum Toxin Injection Improves Depression Scores: A Systematic Review and Meta- Analysis. Plast Reconstr Surg. 2022; (150): 211.
Molina B, Grangier Y, Mole B, Ribe N, Martín Diaz L, Prager W, et al. Patient satisfaction after the treatment of glabellar lines with Botulinum toxin type A (Speywood Unit): A multi-centre European observational study. J. Eur. Acad. Dermatol. Venereol. 2015;(29): 1382-1388.
Finzi E, Rosenthal NE. Emotional proprioception: Treatment of depression with afferent facial feedback. J Psychiatr Res. 2016;(80) 93–96.
Ibragic ́ S, Matak I, Dracˇic ́ A, Smajlovic ́ A, Muminovic ́ M, Proft F, et al. Effects of botulinum toxin type A facial injection on monoamines and their metabolites insensory, limbic and motor brain regions in rats. Neurosci. Lett. 2016; (617): 213–217.
Lewis, M.B. The interactions between botulinum-toxin-based facial treatments and embodiedemotions. Sci. Rep. 2018;(8): 14720.
Gonzalez-Forero D, Pastor AM, Geiman EJ, Benitez-Temino B, Alvarez FJ. Regulation of gephyrin cluster size and inhibitory synaptic currents on Renshaw cells by motor axon excitatory inputs. J Neurosci. 2005; (25): 417–429.
Clowry GJ, Walker L, Davies P. The effects of botulinum neurotoxin A induced muscle paresis during a critical period upon muscle and spinal cord development in the rat. Exp Neurol. 2006; (202):456–469.
Marchand-Pauvert, V., Aymard, C., Giboin, L.S., Dominici, F., Rossi, A., Mazzocchio, R . Beyond muscular effects: depression of spinal recurrent inhibition after botulinum neurotoxin A. J. Physiol. 2013; 591(4):1017-1029.
Makunts T, Wollmer MA, Abagyan R. Postmarketing safety surveillance data reveals antidepressant effects of botulinum toxin across various indications and injection sites. Scientific Reports. 2020;(10):12851.
Zamanian A, Ghanbari Jolfaei A, Mehran G, Azizian Z. Efficacy of Botox versus Placebo forTreatment of Patients with Major Depression. Iran. J. Public Health 2017;(46): 982–984.
Weise D, Weise CM, Naumann M. Central Effects of Botulinum Neurotoxin- Evidence from Human Studies. Toxins. 2019;(11): 21.
Wollmer MA, Magid M, Kruger THC, Finzi E.Treatment of Depression with Botulinum Toxin Toxins 2022; (14): 383
Gilmer WS, Trivedi MH, Rush AJ, Wisniewski SR, Luther J, Howland RH, et al. Factors associated with chronic depressive episodes: a preliminary report from the STAR-D project. Acta Psychiatrica Scandinavica. 2005;(112):425-33.
Choudhury S, Baker MR. Chatterjee S, Kumar H. Botulinum Toxin: An Update on Pharmacology and Newer Products in Development. Toxins. 2021;(13): 58.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Celina Antonio Prata, Aparecido Viana Gomes, Marina Antonio Prata
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
A revista é publicada sob a licença Creative Commons - Atribuição-NãoComercial-SemDerivações 4.0 Internacional.
O trabalho publicado é considerado colaboração e, portanto, o autor não receberá qualquer remuneração para tal, bem como nada lhe será cobrado em troca para a publicação.
Os textos são de responsabilidade de seus autores.
É permitida a reprodução total ou parcial dos textos da revista, desde que citada a fonte.
