Neurotoxins: Expanding uses of neuromodulators in medicine-major depressive disorder

Michelle Magid, Brett H. Keeling, Jason S. Reichenberg

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Botulinum toxin A (BTA) is one of the most diversely used medications of the 21st century and is now being researched as a treatment for major depressive disorder (MDD). Methods: The authors performed a literature search of PubMed, Web of Science, and the Cochrane Register of Controlled Trials. The primary investigators of the studies were contacted for additional unpublished data. Results: The authors identified 5 studies that met the criteria of using BTA in the treatment of MDD. All studies showed significant reduction in depressive symptoms with BTA injected into the glabellar muscles. In a pooled analysis, botulinum toxin (n = 59) vs placebo (n = 75) had a -47% vs -16% reduction in self-rated depression scores (P <0.0001) and a -46% vs -15% reduction in expert-rated depression scores (P <0.0001), respectively. Adverse reactions were mild (temporary headaches and local irritation immediately after injection) and did not differ between active group (13.6%) and placebo group (9.3%) (P = 0.44). Conclusions: Botulinum toxin injections in the glabellar frown muscles have been associated with a significant improvement in depressive symptoms. Given the prevalence of MDD, the promising results of preliminary trials, and the excellent tolerability of this treatment intervention, larger studies are warranted.

Original languageEnglish (US)
Pages (from-to)111S-119S
JournalPlastic and Reconstructive Surgery
Issue number5
StatePublished - 2015

ASJC Scopus subject areas

  • Surgery


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