Glabellar Botulinum Toxin Injection Improves Depression Scores: A Systematic Review and Meta-Analysis.
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 07 2022
01 07 2022
Historique:
pubmed:
20
5
2022
medline:
2
7
2022
entrez:
19
5
2022
Statut:
ppublish
Résumé
Depression is a leading cause of disability worldwide. Preliminary evidence suggests that glabellar onabotulinumtoxinA injections improve depression scores with few side effects compared to current first-line antidepressant medications. The authors' review reports on these studies, hypothesizing that glabellar onabotulinumtoxinA injections can be an alternative safe and effective treatment for depression. A systematic review and meta-analysis of the relevant literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Cochrane Library, Embase, and Scopus databases were searched in August of 2020 using the keywords ["botox" OR "botulinum"] AND ["mood" OR "depression"] for articles published between 1980 and 2020. Prospective studies and randomized controlled trials on the use of glabellar onabotulinumtoxinA injections for the primary purpose of treating depression were considered. The primary endpoint for the meta-analysis was the mean difference in primary depression scores after treatment, along with a second endpoint of the standardized mean difference in depression scores among treated patients including all nine studies. Of the 499 reviewed articles, nine studies were included that reported improvement in mean depression scores from baseline. All five randomized controlled trials reported an improvement in mean depression scores at 6 weeks after treatment, with a weighted average change of -8.39 points ( p < 0.0001). The aggregate standardized mean difference from baseline to the primary endpoint across all nine prospective studies was -1.61 SD ( p < 0.0001). Meta-analysis and systematic review of the included studies provide support for an antidepressant effect of glabellar onabotulinumtoxinA injections.
Sections du résumé
BACKGROUND
Depression is a leading cause of disability worldwide. Preliminary evidence suggests that glabellar onabotulinumtoxinA injections improve depression scores with few side effects compared to current first-line antidepressant medications. The authors' review reports on these studies, hypothesizing that glabellar onabotulinumtoxinA injections can be an alternative safe and effective treatment for depression.
METHODS
A systematic review and meta-analysis of the relevant literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Cochrane Library, Embase, and Scopus databases were searched in August of 2020 using the keywords ["botox" OR "botulinum"] AND ["mood" OR "depression"] for articles published between 1980 and 2020. Prospective studies and randomized controlled trials on the use of glabellar onabotulinumtoxinA injections for the primary purpose of treating depression were considered. The primary endpoint for the meta-analysis was the mean difference in primary depression scores after treatment, along with a second endpoint of the standardized mean difference in depression scores among treated patients including all nine studies.
RESULTS
Of the 499 reviewed articles, nine studies were included that reported improvement in mean depression scores from baseline. All five randomized controlled trials reported an improvement in mean depression scores at 6 weeks after treatment, with a weighted average change of -8.39 points ( p < 0.0001). The aggregate standardized mean difference from baseline to the primary endpoint across all nine prospective studies was -1.61 SD ( p < 0.0001).
CONCLUSION
Meta-analysis and systematic review of the included studies provide support for an antidepressant effect of glabellar onabotulinumtoxinA injections.
Identifiants
pubmed: 35588104
doi: 10.1097/PRS.0000000000009240
pii: 00006534-202207000-00046
doi:
Substances chimiques
Antidepressive Agents
0
Botulinum Toxins, Type A
EC 3.4.24.69
Banques de données
ClinicalTrials.gov
['NCT01392963']
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
211e-220eInformations de copyright
Copyright © 2022 by the American Society of Plastic Surgeons.
Références
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1789–1858.
Brigitta B. Pathophysiology of depression and mechanisms of treatment. Dialogues Clin Neurosci. 2002;4:7–20.
Keller MB. Issues in treatment-resistant depression. J Clin Psychiatry 2005;66(Suppl 8):5–12.
Bauer M, Whybrow PC, Angst J, Versiani M, Möller HJ; World Federation of Societies Biological Psychiatry Task Force on Treatment Guidelines for Unipolar Depressive Disorders. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 1: Acute and continuation treatment of major depressive disorder. World J Biol Psychiatry 2002;3:5–43.
Wollmer MA, Magid M, Kruger THC, Finzi E. The use of botulinum toxin for treatment of depression. Handb Exp Pharmacol. 2021;263:265–278.
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.
Darwin C. The Expression of the Emotions in Man and Animals. 3rd ed. London: Oxford University Press; 1872.
Heckmann M, Ceballos-Baumann A. Botulinum toxin overrides depression: Not surprising, yet sensational. Dermatol Surg. 2007;33:765.
James W. What is emotion? Mind 1884;9:185–205.
Greden JF, Genero N, Price HL. Agitation-increased electromyogram activity in the corrugator muscle region: A possible explanation of the “Omega sign”? Am J Psychiatry 1985;142:348–351.
Brin MF. Development of future indications for BOTOX. Toxicon 2009;54:668–674.
Wollmer MA, de Boer C, Kalak N, et al. Facing depression with botulinum toxin: A randomized controlled trial. J Psychiatr Res. 2012;46:574–581.
Finzi E. Antidepressant effects of botulinum toxin A: Scientific rationale. J Psychiatry Neurosci. 2013;38:E29.
Stearns TP, Shad MU, Guzman GC. Glabellar botulinum toxin injections in major depressive disorder: A critical review. Prim Care Companion CNS Disord. 2018;20:18r02298.
Makunts T, Wollmer MA, Abagyan R. Postmarketing safety surveillance data reveals antidepressant effects of botulinum toxin across various indications and injection sites. Sci Rep. 2020;10:12851.
Zamanian A, Ghanbari Jolfaei A, Mehran G, Azizian Z. Efficacy of Botox versus placebo for treatment of patients with major depression. Iran J Public Health 2017;46:982–984.
Magid M, Reichenberg JS, Poth PE, et al. Treatment of major depressive disorder using botulinum toxin A: A 24-week randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2014;75:837–844.
Brin MF, Durgam S, Lum A, et al. 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.
American Society of Plastic Surgeons. 2019 plastic surgery statistics report. Available at: https://www.plasticsurgery.org/documents/News/Statistics/2019/plastic-surgery-statistics-report-2019.pdf . Accessed March, 2021.
Guo Y, Lu Y, Liu T, et al. Efficacy and safety of botulinum toxin type A in the treatment of glabellar lines: A meta-analysis of randomized, placebo-controlled, double-blind trials. Plast Reconstr Surg. 2015;136:310e–318e.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Int J Surg. 2010;8:336–341.
Hexsel D, Brum C, Siega C, et al. Evaluation of self-esteem and depression symptoms in depressed and nondepressed subjects treated with onabotulinumtoxinA for glabellar lines. Dermatol Surg. 2013;39:1088–1096.
Finzi E, Rosenthal NE. Treatment of depression with onabotulinumtoxinA: A randomized, double-blind, placebo controlled trial. J Psychiatr Res. 2014;52:1–6.
Furukawa TA, Reijnders M, Kishimoto S, et al. Translating the BDI and BDI-II into the HAMD and vice versa with equipercentile linking. Epidemiol Psychiatr Sci. 2019;29:e24.
Heo M, Murphy CF, Meyers BS. Relationship between the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale in depressed elderly: A meta-analysis. Am J Geriatr Psychiatry 2007;15:899–905.
Leucht S, Fennema H, Engel RR, Kaspers-Janssen M, Szegedi A. Translating the HAM-D into the MADRS and vice versa with equipercentile linking. J Affect Disord. 2018;226:326–331.
Svanborg P, Asberg M. A comparison between the Beck Depression Inventory (BDI) and the self-rating version of the Montgomery Asberg Depression Rating Scale (MADRS). J Affect Disord. 2001;64:203–216.
Parsaik AK, Mascarenhas SS, Hashmi A, et al. Role of botulinum toxin in depression. J Psychiatr Pract. 2016;22:99–110.
Higgins J, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions. Version 6.2. London: The Cochrane Collaboration; 2021.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177–188.
Lewis MB. The interactions between botulinum-toxin-based facial treatments and embodied emotions. Sci Rep. 2018;8:14720.
Chugh S, Chhabria A, Jung S, Kruger THC, Wollmer MA. Botulinum toxin as a treatment for depression in a real-world setting. J Psychiatr Pract. 2018;24:15–20.
Finzi E, Wasserman E. Treatment of depression with botulinum toxin A: A case series. Dermatol Surg. 2006;32:645–649; discussion 649–650.
Söderkvist S, Ohlén K, Dimberg U. How the experience of emotion is modulated by facial feedback. J Nonverbal Behav. 2018;42:129–151.
Heller AS, Lapate RC, Mayer KE, Davidson RJ. The face of negative affect: Trial-by-trial corrugator responses to negative pictures are positively associated with amygdala and negatively associated with ventromedial prefrontal cortex activity. J Cogn Neurosci. 2014;26:2102–2110.
Lee H, Heller AS, van Reekum CM, Nelson B, Davidson RJ. Amygdala-prefrontal coupling underlies individual differences in emotion regulation. Neuroimage 2012;62:1575–1581.
Finzi E, Rosenthal NE. Emotional proprioception: Treatment of depression with afferent facial feedback. J Psychiatr Res. 2016;80:93–96.
Reichenberg JS, Hauptman AJ, Robertson HT, et al. Botulinum toxin for depression: Does patient appearance matter? J Am Acad Dermatol. 2016;74:171–173.e1.
Rudolph C, Hladik C, Stroup DF, et al. Are cosmetic procedures comparable to antidepressive medication for quality-of-life improvements? A systematic review and controlled meta-analysis. Facial Plast Surg. 2019;35:549–558.
Lewis MB, Bowler PJ. Botulinum toxin cosmetic therapy correlates with a more positive mood. J Cosmet Dermatol. 2009;8:24–26.
Magid M, Reichenberg JS, Poth PE, et al. Treatment of major depressive disorder using botulinum toxin A: A 24-week randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2014;75:837–844.
Klein AW. Contraindications and complications with the use of botulinum toxin. Clin Dermatol. 2004;22:66–75.
King M. Management of ptosis. J Clin Aesthet Dermatol. 2016;9:E1–E4.
Redaelli A, Forte R. How to avoid brow ptosis after forehead treatment with botulinum toxin. J Cosmet Laser Ther. 2003;5:220–222.