Hawlik A E, Freudenmann R W, Pinkhardt E H, Schönfeldt-Lecuona C J, Gahr M
Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm.
Klinik für Neurologie, Universitätsklinikum Ulm.
Fortschr Neurol Psychiatr. 2014 Feb;82(2):93-9. doi: 10.1055/s-0033-1356093. Epub 2014 Feb 11.
Botulinum toxin (BTX) plays an important role in the treatment and prophylaxis of migraine and is also used for the treatment of focal dystonia, spasm, hypersalivation, and hyperhydrosis. Recent clinical trials suggest that BTX treatment of muscles involved in the development of negative emotions may also have an antidepressant effect. This article gives a systematic review of the literature regarding BTX in the treatment of major depression.
We screened the databases of Medline and Scopus using the search terms [("botulinum toxin" OR "botox") AND ("antidepressant" OR "depression" OR "depressed")]. The website www.clinicaltrials.gov was screened with the same search terms in order to detect current studies.
As of April 2013, we identified 3 studies that evaluated the antidepressant effects of BTX in the treatment of major depression. An improvement in mood after treatment with BTX was seen in a case series of 10 depressed patients. In a randomised, placebo-controlled study of thirty patients assigned to a verum (BTX, n = 15) or placebo (saline, n = 15) group, treatment with BTX has also shown a positive effect on mood. Another prospective, open-label study evaluated the antidepressive effect of BTX in 25 subjects with major depression. On www.clinicaltrials.gov we identified 2 ongoing studies, which are currently investigating the antidepressant effect of BTX.
Recently published studies have shown a reduction of depressive symptoms after treatment of the glabellar frown lines with BTX injections. Further clinical studies in larger patient samples are necessary to prove the efficacy and safety of BTX injections used for the treatment of depressive disorders.
肉毒杆菌毒素（BTX）在偏头痛的治疗和预防中发挥着重要作用，也用于治疗局灶性肌张力障碍、痉挛、唾液分泌过多和多汗症。最近的临床试验表明，用BTX治疗涉及负面情绪产生的肌肉可能也有抗抑郁作用。本文对有关BTX治疗重度抑郁症的文献进行了系统综述。
我们使用检索词[（“肉毒杆菌毒素”或“保妥适”）与（“抗抑郁药”或“抑郁症”或“抑郁”）]筛选了Medline和Scopus数据库。为了查找当前的研究，还使用相同的检索词筛选了网站www.clinicaltrials.gov。
截至2013年4月，我们确定了3项评估BTX治疗重度抑郁症抗抑郁作用的研究。在一个包含10名抑郁症患者的病例系列中，观察到用BTX治疗后情绪有所改善。在一项对30名患者进行的随机、安慰剂对照研究中，将患者分为真药组（BTX，n = 15）或安慰剂组（生理盐水，n = 15），BTX治疗也显示出对情绪有积极影响。另一项前瞻性、开放标签研究评估了BTX对25名重度抑郁症患者的抗抑郁作用。在www.clinicaltrials.gov上，我们确定了2项正在进行的研究，它们目前正在研究BTX的抗抑郁作用。
最近发表的研究表明，用BTX注射治疗眉间皱眉纹后抑郁症状有所减轻。需要在更大的患者样本中进行进一步的临床研究，以证明BTX注射用于治疗抑郁症的有效性和安全性。
