Botox may smooth out depression

Researchers have conducted the largest randomised, double-blind, placebo-controlled study to date on the effect of OnabotulinumtoxinA (OBA, or Botox) on depression. The results of the study, published in the Journal of Psychiatric Research, indicate that more than half of patients injected with the substance demonstrated substantial improvement in their depressive symptoms.

Conducted by Dr Eric Finzi and Dr Norman E Rosenthal, the study assessed 74 subjects who were suffering from DSM-IV major depression. The patients were randomised to receive a single injection of either OBA or a placebo to the corrugator and procerus muscles between the eyebrows. The subjects were rated at screening, and three and six weeks after the treatment.

“The primary outcome measure was the response rate, as defined by ≥50% decrease in score on the Montgomery-Asberg Depression Rating Scale (MADRS),” said the researchers, indicating the diagnostic questionnaire which psychiatrists use to measure the severity of depressive episodes in patients with mood disorders.

“Response rates at six weeks from the date of injection were 52% and 15% in the OBA and placebo groups, respectively.”

The secondary outcome measure was the remission rate. The results found that six weeks after treatment, depressive symptoms (as assessed by the MADRS scale) in the OBA treatment group decreased 47% compared to 21% in the placebo group. Furthermore, the study is said to be the first to show a significant difference in remission rate with OBA in depressed patients (27% OBA vs 7% placebo).

“This research is groundbreaking because it offers those who suffer from depression and their doctors an entirely new approach to treating the condition - one that doesn’t conflict with any other treatments,” said Dr Rosenthal, a clinical professor of psychiatry at Georgetown Medical School.

Dr Finzi, a dermosurgeon, added, “This new research supports earlier facial feedback theory of Charles Darwin and William James which suggests that facial expressions influence mood.” Dr Finzi was co-author on the paper that first reported that inhibition of frowning by facial injection of OBA could help depressed patients, published in 2006.

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