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Facing depression with botulinum toxin: a randomized controlled trial.
J Psychiatr Res 2012; 46(5):574-81JP

Abstract

Positive effects on mood have been observed in subjects who underwent treatment of glabellar frown lines with botulinum toxin and, in an open case series, depression remitted or improved after such treatment. Using a randomized double-blind placebo-controlled trial design we assessed botulinum toxin injection to the glabellar region as an adjunctive treatment of major depression. Thirty patients were randomly assigned to a verum (onabotulinumtoxinA, n = 15) or placebo (saline, n = 15) group. The primary end point was change in the 17-item version of the Hamilton Depression Rating Scale six weeks after treatment compared to baseline. The verum and the placebo groups did not differ significantly in any of the collected baseline characteristics. Throughout the sixteen-week follow-up period there was a significant improvement in depressive symptoms in the verum group compared to the placebo group as measured by the Hamilton Depression Rating Scale (F((6,168)) = 5.76, p < 0.001, η(2) = 0.17). Six weeks after a single treatment scores of onabotulinumtoxinA recipients were reduced on average by 47.1% and by 9.2% in placebo-treated participants (F((1,28)) = 12.30, p = 0.002, η(2) = 0.31, d = 1.28). The effect size was even larger at the end of the study (d = 1.80). Treatment-dependent clinical improvement was also reflected in the Beck Depression Inventory, and in the Clinical Global Impressions Scale. This study shows that a single treatment of the glabellar region with botulinum toxin may shortly accomplish a strong and sustained alleviation of depression in patients, who did not improve sufficiently on previous medication. It supports the concept, that the facial musculature not only expresses, but also regulates mood states.

Authors+Show Affiliations

Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str 27, 4012 Basel, Switzerland. axel.wollmer@unibas.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22364892

Citation

Wollmer, M Axel, et al. "Facing Depression With Botulinum Toxin: a Randomized Controlled Trial." Journal of Psychiatric Research, vol. 46, no. 5, 2012, pp. 574-81.
Wollmer MA, de Boer C, Kalak N, et al. Facing depression with botulinum toxin: a randomized controlled trial. J Psychiatr Res. 2012;46(5):574-81.
Wollmer, M. A., de Boer, C., Kalak, N., Beck, J., Götz, T., Schmidt, T., ... Kruger, T. H. (2012). Facing depression with botulinum toxin: a randomized controlled trial. Journal of Psychiatric Research, 46(5), pp. 574-81. doi:10.1016/j.jpsychires.2012.01.027.
Wollmer MA, et al. Facing Depression With Botulinum Toxin: a Randomized Controlled Trial. J Psychiatr Res. 2012;46(5):574-81. PubMed PMID: 22364892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Facing depression with botulinum toxin: a randomized controlled trial. AU - Wollmer,M Axel, AU - de Boer,Claas, AU - Kalak,Nadeem, AU - Beck,Johannes, AU - Götz,Thomas, AU - Schmidt,Tina, AU - Hodzic,Muris, AU - Bayer,Ursula, AU - Kollmann,Thilo, AU - Kollewe,Katja, AU - Sönmez,Daniela, AU - Duntsch,Katja, AU - Haug,Martin D, AU - Schedlowski,Manfred, AU - Hatzinger,Martin, AU - Dressler,Dirk, AU - Brand,Serge, AU - Holsboer-Trachsler,Edith, AU - Kruger,Tillmann H C, Y1 - 2012/02/24/ PY - 2011/11/30/received PY - 2012/01/24/revised PY - 2012/01/30/accepted PY - 2012/2/28/entrez PY - 2012/3/1/pubmed PY - 2012/8/30/medline SP - 574 EP - 81 JF - Journal of psychiatric research JO - J Psychiatr Res VL - 46 IS - 5 N2 - Positive effects on mood have been observed in subjects who underwent treatment of glabellar frown lines with botulinum toxin and, in an open case series, depression remitted or improved after such treatment. Using a randomized double-blind placebo-controlled trial design we assessed botulinum toxin injection to the glabellar region as an adjunctive treatment of major depression. Thirty patients were randomly assigned to a verum (onabotulinumtoxinA, n = 15) or placebo (saline, n = 15) group. The primary end point was change in the 17-item version of the Hamilton Depression Rating Scale six weeks after treatment compared to baseline. The verum and the placebo groups did not differ significantly in any of the collected baseline characteristics. Throughout the sixteen-week follow-up period there was a significant improvement in depressive symptoms in the verum group compared to the placebo group as measured by the Hamilton Depression Rating Scale (F((6,168)) = 5.76, p < 0.001, η(2) = 0.17). Six weeks after a single treatment scores of onabotulinumtoxinA recipients were reduced on average by 47.1% and by 9.2% in placebo-treated participants (F((1,28)) = 12.30, p = 0.002, η(2) = 0.31, d = 1.28). The effect size was even larger at the end of the study (d = 1.80). Treatment-dependent clinical improvement was also reflected in the Beck Depression Inventory, and in the Clinical Global Impressions Scale. This study shows that a single treatment of the glabellar region with botulinum toxin may shortly accomplish a strong and sustained alleviation of depression in patients, who did not improve sufficiently on previous medication. It supports the concept, that the facial musculature not only expresses, but also regulates mood states. SN - 1879-1379 UR - https://www.unboundmedicine.com/medline/citation/22364892/Facing_depression_with_botulinum_toxin:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3956(12)00038-6 DB - PRIME DP - Unbound Medicine ER -