Botulinumtoxin als neue Option in der Behandlung der Depression

Abstract

Despite effective pharmacological and psychotherapeutic treatment ­options for depression, about one third of patients affected by depression prove resistant to therapy. The injection of botulinum toxin A (BTA) into the glabellar muscles of the forehead constitutes a new approach to treating depression. Such treatment exhibits relatively significant effectiveness and demonstrates considerably different properties than conventional ­antidepressants. BTA injections into the glabella are associated with an ­antidepressant effect lasting several months, which sets them apart from other pharmacological antidepressant interventions thus far. The local ­injection of BTA entails no ­expected pharmacological interactions with other medications. Such properties may make BTA injections a potentially cost-effective alternative to standard antidepressant treatments, exhibiting only very few undesirable events. Three randomized, placebo-controlled clinical studies have demonstrated the effectiveness of BTA treatment for patients affected by unipolar depressive disorder. Studies conducted to date display a few ­methodological weaknesses. The sample size in the individual studies ­tended to be small, with blinding methods for BTA treatment being not ideal. Currently, several hypotheses are under discussion concerning the mechanism of action of BTA treatment, namely the information-processing hypothesis, the aesthetic hypothesis, as well as the social hypothesis.