Botox for Depression

Botox for Depression: New Study Shows Promising Findings

Everyone has heard of Botox, and many know of its amazing benefits outside of aesthetic use.  Botox was first approved for therapeutic use more than three decades ago. It was developed as a treatment for eye muscle disorders like blepharospasm (involuntary blinking) and strabismus (crossed eyes). Over the years, doctors found they could use Botox to treat a variety of health conditions. As the use of Botox has increased over the years, a surprising finding has emerged. People who receive Botox, whether it is for cosmetic reasons or a medical condition, have significantly lower rates of depression.  Furthermore, we here at Village Dermatology have had a myriad of patients over the years that do not have a clinical diagnosis of depression, express a “mood-lifting” benefit after receiving their Botox treatment. So, when this study came out, we were very intrigued to read this information.  This is our attempt at summarizing the information in the study.  If you want to read the entire study, we have provided a link at the bottom of this article.

 Depression: A Global Disease

According to the World Health Organization (WHO), more than 250 million people worldwide suffer from depression. In the United States, major depression is one of the most common mental health disorders. More than 17 million Americans report at least one major depressive episode in the past year, representing roughly 7% of the population.

Depression can result in severe functional impairment. It interferes with a person’s ability to carry out day-to-day activities. Symptoms of depression include sadness, anxiety, and a lack of interest in previously enjoyed activities. Depressed people are often irritable, frustrated, and restless. They may suffer from sleep and appetite disturbances. Feelings of worthlessness, helplessness, and guilt are common. Depression can also lead to trouble with concentration, decision making, and memory.

Due to its profound impact on a person’s health and quality of life, it’s important to recognize and treat depression.

Uses of Botox: Much More Than Facial Rejuvenation

Botox is best known for its use in facial rejuvenation. Botox injections for the treatment of facial wrinkles are the most commonly performed cosmetic procedures in the United States. They’re a safe, FDA-approved treatment to get rid of crow’s feet and frown lines. But what many people don’t know is that Botox is also approved for several medical conditions besides cosmetic use, including:

  • Hyperhidrosis (abnormal sweating not related to heat or exercise)
  • Migraine prevention
  • Neurogenic bladder (lack of bladder control due to nerve problems)
  • Overactive bladder (uncontrolled urge to urinate)
  • Urinary incontinence (loss of bladder control)
  • Spasticity (tight or stiff muscles)

Botox for Depression: Yes, It Works

Over the last decade, several clinical trials and studies have shown that facial Botox injections are very effective in treating depression. However, many doctors remain unconvinced because some of these studies were small. Also, it was not possible to reliably blind the patients (in a double-blind clinical trial, the patient and physician do not know whether the patient is receiving the actual drug versus a placebo). Due to the obvious cosmetic effects of Botox, it hasn’t been possible to conduct a double-blind trial in cosmetic patients.

Moreover, the mechanism by which Botox has an antidepressant effect remains unclear. It is thought that Botox relaxes the “grief muscles” that are used to express negative emotions like sadness, anger, and fear. This breaks the feedback from the face to the brain that reinforces these emotions.

New Study Results: Botox Can Treat Depression

A new study has looked at more than 45,000 clinical reports of adverse events related to Botox injections submitted to the FDA. These reports include Botox treatments not only for cosmetic purposes but also for other frequent medical indications and injection sites. In total, the authors looked at over 13 million reports submitted voluntarily to the FDA’s MedWatch program by physicians, other healthcare providers, and patients. The reports related to patients on treatment with antidepressants were eliminated from the study to avoid confusion.

The results showed that patients who received Botox had a significantly lower incidence of depression. The study confirmed the antidepressant effect of facial Botox injections shown by previous clinical trials. Surprisingly though, the antidepressant effect of Botox was also noted for other sites of injection and medical conditions. In other words, when Botox was used for migraine prevention, muscle spasms, torticollis (neck pain), blepharospasm (involuntary blinking), hyperhidrosis (excessive sweating), urinary bladder disorders, and sialorrhea (excessive salivation or drooling), it had an antidepressant effect.

The authors of the study believe the mechanism of action of Botox in treating depression is more complex than simply grief muscle paralysis. But what’s clear is that cosmetic facial Botox injections in the glabellar region (between the eyebrows) have a protective effect against depression and its symptoms. This means, in the future, Botox could potentially be used to treat depression. However, further clinical studies are needed before Botox is approved as a treatment for depression.

Link to study   https://www.nature.com/articles/s41598-020-69773-7.pdf

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