Botulinum Toxin Type A in the Treatment of Major Depressive Disorder: A Literature Review
DOI:
https://doi.org/10.14295/idonline.v20i81.4401Keywords:
Major Depressive Disorder, Botulinum Toxin Type A, Major Depressive DisordeFacial Feedback, Neurobiology of Depression, Adjunctive TreatmentAbstract
Major Depressive Disorder (MDD) constitutes a multifactorial psychiatric condition associated with emotional, cognitive, and neurobiological alterations that significantly impact individuals' quality of life, representing a relevant public health issue. Considering the limitations of conventional treatments currently available and the presence of treatment-resistant depression, new therapeutic approaches have been investigated, among which the use of botulinum toxin type A as an adjunctive strategy stands out. This study aimed to analyze, through an integrative literature review, the scientific evidence regarding the efficacy of botulinum toxin type A in the treatment of MDD, as well as its possible mechanisms of action. The search was carried out in the LILACS and MEDLINE/PubMed databases using descriptors standardized by DeCS and MeSH, combined with Boolean operators. Articles published in the last twenty years in Portuguese, English, and Spanish were included. After applying the eligibility criteria and following the PRISMA 2020 recommendations, 21 studies comprised the final sample. The results demonstrated a significant reduction in depressive symptoms, especially after application in the glabellar region, with response onset between the second and sixth week. The studies also suggest that the mechanism of action is related to the facial feedback theory and the modulation of neural circuits involved in emotional regulation. Despite the methodological limitations observed, these findings indicate that botulinum toxin type A represents a promising and safe complementary therapeutic strategy in the treatment of MDD, especially in cases of partial response to conventional treatments.
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