Treatment of post-traumatic stress disorder using botulinum toxin a

Abstract

Methods are disclosed for treating post traumatic stress disorder (PTSD) in a subject. The methods include administering a therapeutically effective amount of a neurotoxin to a corrugator supercilli and/or a procerus muscle of the subject to cause paralysis of the corrugator supercilli and/or a procerus muscle in the subject, thereby treating PTSD. The neurotoxin can be Botulinum toxin A, such as at a dose of about 20 to about 50 units of Botulinum toxin A.

1 . A method for treating post traumatic stress disorder (PTSD) in a human subject, comprising administering a therapeutically effective amount of a Botulinum toxin to a corrugator supercilii and/or a procerus muscle of the human subject to cause paralysis of the corrugator supercilii and/or the procerus muscle, respectively, thereby treating the PTSD in the human subject. 
     
     
         2 . The method of  claim 1 , wherein the human subject does not have any other psychiatric disorder. 
     
     
         3 . The method of  claim 1 , wherein the human subject does not have a muscular disorder. 
     
     
         4 . The method of  claim 1 , wherein the Botulinum toxin is Botulinum toxin A. 
     
     
         5 . The method of  claim 4 , wherein about 20-50 Unit equivalents of Botulinum toxin type A are administered to the corrugator supercilii and the procerus muscle in the human subject. 
     
     
         6 . The method of  claim 5 , further comprising administering an additional dose of about 20-50 Unit equivalents of Botulinum toxin type A to the corrugator supercilii and the procerus muscle after about two to six months. 
     
     
         7 . A method for treating post traumatic stress disorder (PTSD) in a human subject, comprising
 selecting a human subject with PTSD, and   administering a therapeutically effective amount of about 20 to about 40 Unit equivalents of Botulinum toxin A to a corrugator supercilii muscle and/or a procerus muscle of the human subject to cause paralysis of the corrugator supercilii muscle and/or the procerus muscle, respectively,   thereby treating the PTSD in the subject, wherein the human subject does not have an underlying muscular physical condition.   
     
     
         8 . The method of  claim 7 , wherein about 29 to about 40 Unit equivalents of Botulinum toxin type A are administered to the corrugator supercilii muscle and the procerus muscle of the human subject. 
     
     
         9 . The method of  claim 8 , further comprising administering an additional dose of about 30-60 Unit equivalents of Botulinum toxin type A to the corrugator supercilii muscle and the procerus muscle after about two to six months. 
     
     
         10 . The method of  claim 7 , further comprising administering to the human subject a therapeutically effective amount of an additional modality of treatment. 
     
     
         11 . The method of  claim 10 , wherein the additional modality of treatment comprises administration of an antidepressant, psychotherapy, a beta blocker, or behavioral therapy. 
     
     
         12 . The method of  claim 10 , wherein the additional modality of treatment comprises Selective Serotonin Reuptake Inhibitor (SSRI), an alpha adrenergic antagonist, an anti-convulsant, a mood stabilizer, an anti-psychotic, a beta blocker, a bezodiazepine, a glucocorticoid, monoamine-oxidase inhibitor (MAOIs), a heterocyclic anti-depressant, or a tricyclic anti-depressant. 
     
     
         13 . The method of  claim 7 , further comprising performing a psychological assessment on the human subject. 
     
     
         14 . The method of  claim 13 , wherein the human subject reports one or more of: (1) decreased efforts to avoid thoughts, feelings, or conversations associated with the trauma; (2) decreased efforts to avoid activities, places, or people that arouse recollections of the trauma; (3) increased recall of aspect of the trauma (memory); (4) increased interest or participation in significant activities; (5) fewer feelings of detachment or estrangement from others; (6) an increased range of affect (e.g., able to show loving feelings); and (7) a better sense of the future, following the administration of Botulinum toxin A. 
     
     
         15 . The method of  claim 13 , wherein the human subject reports one or more of (1) less difficulty falling or staying asleep; (2) less irritability or outbursts of anger; (3) less difficulty concentrating; (4) less hypervigilance; and (5) a less exaggerated startle response, following the administration of Botulinum toxin A. 
     
     
         16 . The method of  claim 1 , wherein the human subject is female. 
     
     
         17 . The method of  claim 7 , wherein the human subject is a female. 
     
     
         18 . The method of  claim 1 , further comprising administering electroconvulsive therapy, light therapy, or electromagnetic radiation to the human subject. 
     
     
         19 . The method of  claim 1 , wherein the PTSD was caused by combat exposure, child abuse, a terrorist attack, assault, an accident, or a natural disaster. 
     
     
         20 . The method of  claim 3 , wherein the psychiatric disorder is schizophrenia, depression, an anxiety disorder, or an obsessive-compulsive disorder. 
     
     
         21 . The method of  claim 10 , wherein the additional modality is citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, carbamazepine, Topiramate, Zolpidem, Lamotrigine, Valproic acid, lithium carbonate, buspirone, Prazosin, risperidone, propanolol, cortiosterone, amitriptyline, imipramine, or phenelzine.