Depression is frequently accompanied by a specific sad facial expression. This expression is in part mediated by the same muscle activity that produces frown lines. Based on the assumption that there is a positive feedback between depressed mood and the correspondent facial muscle activity (facial feedback) the investigators will conduct a randomized controlled pilot study in which the investigators will apply a classical cosmetic treatment of frown lines with injections of botulinum toxin to depressed patients who did not sufficiently respond to antidepressant medication. The investigators hypothesize that this treatment will contribute to the amelioration of depressive symptoms in these patients. This hypothesis is supported by a previous open case series in which remission of depression was reported after such treatment (Finzi and Wasserman, 2006).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
30
A total of 20-50 U of clostridium botulinum toxin type A neurotoxin complex (Allergan) will be injected at four to six sites in the glabella region according to standard protocols of cosmetic botulinum toxin applications.
0.9% NaCl solution will be injected in analogy to clostridium botulinum toxin type A neurotoxin complex as a placebo comparator.
Medical School Hannover, Psychiatry, Social Psychiatry and Psychotherapy
Hanover, Germany
Psychiatry Hospital of the University of Basel, Basel, Switzerland
Basel, Basel Town, Switzerland
Response rate (reduction in Ham-D score by >30% compared to baseline)
Time frame: six weeks
Remission rate (number of patients with HAM-D score < 8)
Time frame: six weeks
Time to response (20% reduction of HAM-D score compared to baseline)
Time frame: two, four, or six weeks
response by self rating (BDI)
Time frame: six weeks
need for additional treatment
Time frame: eight weeks, twelve weeks, or sixteen weeks
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