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DOI: 10.1055/s-0033-1356093
Botulinumtoxin bei der Behandlung depressiver Störungen
Eine systematische ÜbersichtBotulinum Toxin for the Treatment of Major Depressive DisorderA Systematic ReviewPublication History
Publication Date:
11 February 2014 (online)
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Zusammenfassung
Hintergrund: Botulinumtoxin (BTX) spielt bei der Behandlung und der Prophylaxe der chronischen Migräne eine wichtige Rolle und wird zudem bei der Behandlung fokaler Dystonien, von Spastik, Hypersalivation und bei Hyperhydrosis eingesetzt. Es wird auch eine antidepressive Wirkung von BTX-Injektionen in Muskelgruppen im Gesicht, die negative Emotionen ausdrücken, diskutiert. In dieser Übersichtsarbeit soll die derzeit verfügbare Evidenz im Hinblick auf eine antidepressive Wirkung von BTX vorgestellt und diskutiert werden.
Methoden: Mehrere Datenbanken wurden systematisch mit dem Suchterminus [(„botulinum toxin“ OR „botox“) AND („antidepressant“ OR „depression“ OR „depressed“)] durchsucht. Zudem wurde auf der Website www.clinicaltrials.gov nach gegenwärtig laufenden Studien geschaut.
Ergebnisse: Bis April 2013 wurden 3 Studien publiziert, die die antidepressive Wirkung von BTX-Injektionen untersuchten und nachweisen konnten: Eine Fallsammlung von 10 depressiven Patientinnen, denen BTX injiziert wurde; eine randomisierte, doppelblinde und placebokontrollierte Studie mit 30 an einer Depression erkrankten Probanden, die einer Verum- und einer Placebogruppe zugeteilt worden waren; eine prospektive, offene Studie mit je 25 depressiven und gesunden Probanden. Es fanden sich zudem 2 laufende Studien, die den antidepressiven Effekt dieser Therapie untersuchen.
Schlussfolgerungen: Die aktuell veröffentlichten Studien konnten eine Reduktion depressiver Symptome nach der Applikation von BTX in die Glabella zeigen. Weitere klinische Studien an größeren Kollektiven sind für den Nachweis der Wirksamkeit und Sicherheit von BTX-Injektionen bei der Behandlung depressiver Störungen notwendig.
Abstract
Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
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