Treating Depression with Botulinum Toxin: A Pooled Analysis of Randomized Controlled Trials

M. Magid, E. Finzi, T. H C Kruger, H. T. Robertson, B. H. Keeling, S. Jung, J. S. Reichenberg, N. E. Rosenthal, M. A. Wollmer

Research output: Contribution to journalArticle

27 Scopus citations


Introduction: Botulinum toxin A (BTA) injection into the glabellar region is currently being studied as a treatment for major depressive disorder (MDD). Here we explore efficacy data of this novel approach in a pooled analysis. Methods: A literature search revealed 3 RCTs on this topic. Individual patient data and clinical end points shared by these 3 trials were pooled and analyzed as one study (n=134) using multiple regression models with random effects. Results: In the pooled sample, the BTA (n=59) and the placebo group (n=75) did not differ in the baseline variables. Efficacy outcomes revealed BTA superiority over placebo: Improvement in the Hamilton Depression Rating Scale or Montgomery-Asberg Depression Rating Scale 6 weeks after baseline was 45.7% for BTA vs. 14.6% for placebo (p<0.0001), corresponding to a BTA response rate of 54.2% (vs. 10.7%) and a BTA remission rate of 30.5% (vs. 6.7%). Discussion: Equalling the status of a meta-analysis, this study increases evidence that a single treatment of BTA into the glabellar region can reduce symptoms of MDD. Further studies are needed to better understand how BTA exerts its mood-lifting effect.

Original languageEnglish (US)
Pages (from-to)205-210
Number of pages6
Issue number6
Publication statusPublished - Aug 7 2015



  • antidepressant
  • botulinum neurotoxin A
  • meta-analysis
  • relaxation

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Psychiatry and Mental health

Cite this

Magid, M., Finzi, E., Kruger, T. H. C., Robertson, H. T., Keeling, B. H., Jung, S., ... Wollmer, M. A. (2015). Treating Depression with Botulinum Toxin: A Pooled Analysis of Randomized Controlled Trials. Pharmacopsychiatry, 48(6), 205-210.