Potential Role of Botulinum Neurotoxin Type A as a Supportive Intervention for Depressive Symptoms: A Systematic Review.

BACKGROUND

Depression is a major global health issue. Recent studies suggest that botulinum toxin (BoNT/A), commonly used in aesthetic procedures, might have potential as an adjunct to traditional treatments for depressive symptoms. It is hypothesized that BoNT/A could influence neurochemical pathways to help alleviate depressive symptoms.

METHODS

A systematic literature review was conducted focusing on Botulinum Neurotoxin Type A (BoNT/A) for depressive disorders. Primary studies published in English were included. Data were extracted on injection sites, dosage, adverse events, and outcomes. Statistical analysis included chi-squared tests and logistic regression to identify treatment predictors.

RESULTS

Twelve studies were included, primarily targeting the glabellar region with BoNT/A injections. Approximately 71% of patients demonstrated reductions in depression symptoms. The chi-square test revealed a significant association between injection sites and depression improvement (p = 0.009). Higher doses of BoNT/A showed a marginally negative relationship with depression reduction (p = 0.098). Most adverse effects were mild, such as local site reactions and mild headaches, with no severe adverse events like suicidal ideation reported.

CONCLUSIONS

This review describes the possible use of BoNT/A as an adjunct therapy for depressive symptoms, particularly when targeting facial muscles. Further research is needed to optimize dosage and explore the neurobiological mechanisms involved to improve therapeutic outcomes.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .