Botox for Depression: A New Use for Neurotoxins

We’ve all heard the phrase, ‘Look better, feel better.’ And you and I know this to be true! That feeling of stepping out of the med spa after a treatment is unmatched. But now, research is here to back up our Botox habit for its ability to not only smooth fine lines and wrinkles but also to help improve depressive symptoms.

Cosmetically, Botulinum toxin type A (Botox) works to relax wrinkles, smooth fine lines and contour facial structure by inactivating nerves that stimulate muscles to contract. It blocks the release of acetylcholine, a neurotransmitter, from the nerve. Within 24 to 48 hours, patients begin to notice a decrease in moderate to severe frown lines, crow’s feet and forehead wrinkles, with full results in 30 days.

Botulinum toxin type A has been used for more than 40 years for a multitude of applications. It was first studied in humans in 1978, when surgeons received FDA permission to study the drug for ophthalmic uses. In 1989, the FDA approved Allergan’s botulinum toxin type A, now well-known to all of us as Botox. In 2002, Botox earned FDA approval for treating frown lines, those wrinkles between our eyebrows.

Today, in addition to relaxing wrinkles, the neurotoxin is used to treat migraines, twitching eyes, overactive bladders, sweaty palms and more. And while it’s improvement of depressive symptoms has been considered an off-label use, recent research lends credence to its efficacy in improving one’s mood.

In a systematic review of randomized controlled trials published in the December 2020 issue of Psychiatry, researchers found a statistically significant improvement in depressive symptoms with the injection of botulinum toxin among patients with major depressive disorder. This is compared to patients who received a placebo treatment.

Anecdotally, improved mood as a side effect of cosmetic neurotoxin injections is something that those of us in the dermatology field have noticed among our patients for years. However, confounding factors such as medications, injection/acupuncture effect, physician interaction or touch, and other life scenarios have made it challenging to discern Botox’s true effect on mood or psychiatric diagnosis.

This study supports the use of Botox, not just for cosmetic reasons within the dermatology realm, but for improvement of improved mood and psychological state as well.

For patients considering Botox for its ability to help with depressive symptoms, I urge you to please have an honest conversation with your dermatologist so that they can assure that you receive the very best care, not only for your external appearance but also for optimal mental health.

Research shows that neurotoxins can help symptoms of depression. However, this treatment is ONLY as an adjunct to — NOT in place of — needed psychiatric care with your primary physician or mental health team.

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Congratulations to Dr. Trizna on his upcoming retirement July 19!