Botulinum toxin relieves anxiety and depression in patients with hemifacial spasm and blepharospasm

Abstract

Objective To explore the efficacy of botulinum toxin type A (BTX-A) therapy in relieving anxiety and depression in patients with hemifacial spasm (HFS) and benign essential blepharospasm (BEB). Patients and method Ninety idiopathic HFS patients and 90 BEB patients were enrolled. The anxiety and depression status were evaluated by self-rating anxiety scale (SAS) and self-rating depression scale (SDS), respectively, before and after the injection of BTX-A. Results Before treatment, the SAS and SDS scores of HFS patients were 41.25±6.35 and 42.25±7.57, respectively. The SAS scores were 40.17±8.36 for males and 43.56±6.10 for females ( P =0.031). The SDS scores were 40.25±6.46 for males and 45.48±7.31 for females ( P =0.008). After treatment, the SAS and SDS scores were 30.12±4.35 and 30.58±4.89, respectively. There was a significant difference in the SAS and SDS scores before and after treatment. Before treatment, the SAS scores of male and female BEB patients were 56.45±8.75 and 60.89±9.11, respectively, and the SDS scores of male and female BEB patients were 57.90±7.93 and 60.12±8.35, respectively. After treatment, the SAS score was 38.17±3.67 and the SDS score was 38.12±4.15, with a significant difference in before and after treatment scores. Conclusion In HFS and BEB, especially in female patients, there is an association with anxiety and depression. BTX-A can improve the symptoms of anxiety and depression.

Postmarketing safety surveillance data reveals antidepressant effects of botulinum toxin across various indications and injection sites

“…Moreover, we show that BoNT injections in body regions other than the glabella also have a protective effect against depression in several burdensome medical conditions that are associated with a high risk for comorbid depression. This is also in line with the previous literature 60 – 62 . This implies the possibility that in addition to, or even instead of, the proposed facial feedback mechanism other mechanisms of action may account for the antidepressant effect of BoNT.…”

Impact and Challenges of the COVID-19 Pandemic on Patients Requiring Botulinum Toxin A Treatment

“…13,33,34 It has been known that apart from controlling motor symptoms, BoNT-A also improves the symptoms of anxiety and depression. 35 Due to the present situation, the administration of BoNT-A has been delayed for most patients, as it has been classified as nonurgent. 36 Indeed, most movement disorder centers worldwide have suspended the provision of BoNT-A during this period; however, it was recommended that this important service be reestablished to alleviate pain and disability among our patients.…”

Blepharospasm and Hemifacial Spasm

“…Blepharospasm patients suffer more depression and anxiety than their healthy counterparts, and these psychiatric conditions are theorized to be involved in both the origin and the result of social stigmata due to undesirable negative facial expressions [19][20][21][22]. BEB patients score worse than healthy individuals as well as hemifacial spasm patients on vision-specific measures of health-related quality of life (HRQOL), as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) [19,23].…”