{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:50:46Z","timestamp":1790905846616,"version":"4.1.0"},"reference-count":80,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Botulinum toxin type A (BONT-A) has shown promise in improving the mood-related symptoms of psychiatric disorders by targeting muscles linked to the expression of negative emotions. We conducted a systematic review of past and ongoing efficacy trials of BONT-A therapy for psychiatric disorders to identify relevant trends in the field and discuss the refinement of therapeutic techniques. A comprehensive search for published clinical trials using BONT-A injections for psychiatric disorders was performed on 4 May 2023 through OVID databases (MEDLINE, Embase, APA PsycINFO). Unpublished clinical trials were searched through the ClinicalTrials.gov and International Clinical Trial Registry Platform public registries. The risk of bias was assessed using the JBI Critical Appraisal tools for use in systematic reviews. We identified 21 studies (17 published, 4 unpublished clinical trials) involving 471 patients. The studies focused on evaluating the efficacy of BONT-A for major depressive, borderline personality, social anxiety, and bipolar disorders. BONT-A was most commonly injected into the glabellar area, with an average dose ranging between 37.75 U and 44.5 U in published studies and between 32.7 U and 41.3 U in unpublished trials. The results indicated significant symptom reductions across all the studied psychiatric conditions, with mild adverse effects. Thus, BONT-A appears to be safe and well-tolerated for psychiatric disorders of negative affectivity. However, despite the clinical focus, there was a noted shortage of biomarker-related assessments. Future studies should focus on pursuing mechanistic explorations of BONT-A effects at the neurobiological level.<\/jats:p>","DOI":"10.3390\/toxins16040191","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T10:24:26Z","timestamp":1713176666000},"page":"191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Botulinum Toxin Injections for Psychiatric Disorders: A Systematic Review of the Clinical Trial Landscape"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7876-4981","authenticated-orcid":false,"given":"Ilya","family":"Demchenko","sequence":"first","affiliation":[{"name":"Interventional Psychiatry Program, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King\u2019s College Circle, Toronto, ON M5S 1A8, Canada"},{"name":"Institute for Biomedical Engineering, Science, and Technology (iBEST), Keenan Research Centre for Biomedical Science, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 209 Victoria Street, Toronto, ON M5B 1T8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4521-7852","authenticated-orcid":false,"given":"Alyssa","family":"Swiderski","sequence":"additional","affiliation":[{"name":"Interventional Psychiatry Program, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Liu","sequence":"additional","affiliation":[{"name":"Interventional Psychiatry Program, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyejung","family":"Jung","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Lou","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkat","family":"Bhat","sequence":"additional","affiliation":[{"name":"Interventional Psychiatry Program, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King\u2019s College Circle, Toronto, ON M5S 1A8, Canada"},{"name":"Institute for Biomedical Engineering, Science, and Technology (iBEST), Keenan Research Centre for Biomedical Science, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 209 Victoria Street, Toronto, ON M5B 1T8, Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada"},{"name":"Neuroscience Research Program, St. Michael\u2019s Hospital\u2014Unity Health Toronto, 209 Victoria Street, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2022). 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