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Botox injections can relieve depression



Doctors administer Botox to smooth facial wrinkles and treat health problems such as heavy sweating, uncontrolled blinking, chronic migraines, overactive bladders, and neurological disorders that cause muscle contractions and neck and shoulder pain.

Botox, a drug made from a toxin produced by the bacterium Clostridium botulinum, works by weakening or paralyzing specific muscles or blocking certain nerves.
More than 264 million people worldwide suffer from depression. But general treatments for depression are not effective for nearly a third of these people, even if they stick to their treatment plans and tolerate medication, according to a study published Thursday in the journal Scientific Reports.
This shortcoming has led doctors to explore alternative treatments, such as doses of psilocybin (the active ingredient in psychedelic fungi), ketamine infusions and, more recently, Botox injections. Previous studies over the past 1
5 years have found that the drug may have antidepressant effects.
One dose of the drug

How and for how long treatment can work in depression is unclear, but researchers believe that Botox can disrupt the feedback cycle between negative facial expressions in the glabella area – behind the skin between the eyebrows and above the nose, where our “muscle grief” – and negative emotions. Because of this hypothesis, these studies mainly used forehead injections to try to treat depression, but were limited in terms of sample size, shaky methodologies, injection sites, and mixed results.

Botox for different conditions

To address the limitations of previous studies, the researchers analyzed more than 45,000 reports of adverse events caused by Botox treatment from the US Food and Drug Administration’s Adverse Event Reporting System. The system supports the monitoring of adverse drug reactions reported by patients, healthcare professionals and FDA manufacturers through MedWatch, the FDA’s safety program and adverse event reporting.
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They divided patients into eight groups according to medical symptoms, which were most often treated with Botox. It was:

  • cosmetic use against wrinkles, face lifts, skin fillers, etc.
  • migraine
  • limb cramps or spasticity (when muscles tense or tense and interfere with movement, speech and walking)
  • neck pain
  • involuntary blinking or eyelid spasm
  • excessive sweating
  • excessive dousing
  • neurological and urinary disorders of the bladder

Each cohort was divided into two groups, in which one group received Botox on its own terms and the other did not. Patients who received Botox injections to treat excessive sweating, facial wrinkles, migraines, spasticity, and spasms reported depression 40% to 88% less often than people who received different treatments under the same conditions.

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“We found that the (effect) does not depend on the injection site, and it does not depend on (medical conditions), which are quite diverse for Botox,” said Ruben Abadian, lead author of the study and professor of pharmacy and pharmaceutical sciences. Skaggs at the University of California, San Diego.

“The consequences of this are fascinating, because it means that depression can be cured by various (means), and not necessarily by injections into one of the facial muscles, which in some cases may be undesirable,” – added Abagyan.

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Although the facial feedback hypothesis is a “plausible and reasonable mechanism,” the study notes, the findings may suggest that there are other, more complex ways in which Botox may have antidepressant effects.

Botox can be transported to the structures of the central nervous system that are involved in regulating our mood and emotions. A 2019 study found that Botox injections for muscle spasms can go beyond the injection site and affect opposite muscle groups and reflexes through changes in nerve activity.

“Part of it gets into the systemic distribution through the bloodstream … and then somehow gets into the brain and possibly affects different places,” which may be related to depression, Abagyan said.

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The interaction between muscles and mood is not limited to the process of facial feedback.

Muscle tension in various areas of the body is a common symptom of depression and can be both a physical manifestation of the disorder and an increase in depressed mood. That is why progressive muscle relaxation, which mentally relaxes a person by tensing and then relaxing their muscles, is a well-established treatment in psychiatry.
Depression is associated with increased muscle tone, which describes the maintenance of partial muscle contraction. Decreased muscle tone as a result of Botox injections, which weaken the muscles, can counteract depression.

“Imagine that when you are depressed, there is more than one place on the forehead – which forms this gloomy wrinkle,” but all the muscles tense and contract, “said Abagyan.” Then there is a distributed muscle memory. By breaking this memory, basically by relaxing them, you are breaking the feedback between the head and the muscles in this case. ”

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Because some of these conditions are chronic and aggravating, they can cause secondary psychiatric problems, such as depression. If Botox eliminates these problems, it could lead to depression.

“This study makes me wonder if muscle spasms or sweating can also cause us a physical feeling of depression, and by treating this ‘feeling of depression’ we can affect not only the patient’s medical problem (but also their psychological well-being).” , – said in an email Dr. Jason Reichenberg, a dermatologist at Ascension Medical Group and an associate professor of internal medicine at the University of Texas at Austin. Reichenberg did not participate in the study.

The future of Botox

Because the FDA’s reporting system is voluntary and open to the public, adverse reactions to Botox could be underestimated and biased, the study said. Other details about demographics, dose and duration of treatment, medical records, and other medications or supplements were also limited.

Studies of past data cannot establish a “cause-and-effect relationship, but they help us focus our future research,” Reichenberg said. “The results are even more impressive when you realize that the authors removed any patients who were taking antidepressants so as not to be biased; their results could be even stronger if they kept that data.”

Researchers have suggested that Botox injections may be an alternative treatment for those who are unlucky with common treatments for depression, as well as for those who experience both chronic conditions and depression.

“If someone needs to be treated for excessive salivation, cramps or a tilted head, and they are depressed at the same time, the discovery shows that (Botox) can be useful for both indications,” Abagyan said. “If you can kill two birds with one stone, I think it’s definitely worth considering.”

Depression carries as much danger as the risk of suicide, but Botox injections do the same if the doses are disproportionate to what patients can cope with, Abagyan said. Additional research is needed on Botox treatment for depression to understand the potential side effects and provide a safe path to mental recovery.


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