What is Botox?
Botox is a substance derived from botulinum toxin A that temporarily paralyzes muscles. You’re probably familiar with its use in cosmetic procedures to reduce the appearance of fine lines and wrinkles. However, it can also help with excessive sweating, migraines, and muscle spasms.
New research suggests that Botox may be an effective treatment for depression. Depression is a common mental health condition marked by ongoing feelings of hopelessness and sadness. Many people use a combination of antidepressant medications and therapy to help manage their symptoms.
However, some people can experience uncomfortable side effects from antidepressants. Some people also have to try a few different antidepressants before they find one that works well for them.
Botox may be an effective treatment option for depression used alongside antidepressants. However, research is still ongoing.
Keep reading to learn more about the recent research surrounding Botox’s use for depression, as well as the procedure and risks involved.
What does the research say?
The idea of using Botox to treat depression seems to originate in a small 2006 study involving 10 participants with depression. They were all given a Botox injection in their glabellar frown lines. These are the lines between your eyes that tend to show up when you frown or scowl.
Two months after the injection, nine of the participants no longer had depression symptoms. While the 10th participant still had some symptoms, they reported an improved mood.
Based on the 2006 study, a 2012 study looked at 30 people with symptoms of depression who were already receiving treatment with antidepressants. Over 16 weeks, half of the participants received Botox injections. The other half received a placebo saline injection. This study also used the glabellar frown lines as the injection site.
Participants who received a Botox injection reported a 47.1 percent decrease in their symptoms six weeks after a single injection. The placebo group noted a 9.3 percent reduction.
While small, this study is still notable. It suggests that Botox may take as few as six weeks to start having a noticeable effect on mood following a single treatment. When they work, antidepressants take about six to eight weeks to start working. They can take several months for some people.
Another study involving 30 participants with depression came to similar conclusions. Participants received an injection of either Botox or a placebo in their glabellar frown lines. They were evaluated every three weeks for 24 weeks. Those who received the Botox injection reported improved symptoms, even after 24 weeks. This is significant: Botox’s cosmetic effects last about 12 to 16 weeks, suggesting that its effects on depression last much longer.
Like previous studies, a 2017 Iranian study evaluated 28 participants with depression over six weeks. They too received Botox injections in their glabellar frown lines. Botox was also used alongside their antidepressant treatment. By the end of the study, symptoms of depression improved more in the participants who received Botox compared to those who received a placebo.
What are the benefits?
While the results of these studies are promising, researchers are still trying to figure out exactly how Botox treats depression. Initially, they thought the antidepressant effects of Botox might be related to improved appearance. Having fewer wrinkles, they hypothesized, might improve someone’s mood.
However, a 2016 review of the earlier studies found that the severity of a person’s frown lines didn’t impact their results. For example, people with very few frown lines still reported similar results. This suggests that improved appearance isn’t a factor.
A more likely explanation of the benefits of Botox for depression has to do with a “facial feedback” mechanism. Facial expressions send certain feedback to the brain. Emotions like fear, sadness, or anger can result in the contraction of muscles in the forehead that cause the glabellar frown lines. In people who are depressed, activity of the muscles that cause these frowns is increased. Blocking these frowning muscles with Botox may result in improved mood.
How is it done?
Your doctor can give you Botox injections as part of a quick, in-office procedure. However, you might want to look around for a doctor who specializes in giving Botox injections or ask your primary doctor for a referral. Keep in mind that Botox isn’t approved by the U.S. Food and Drug Administration to treat depression, so your insurance plan likely won’t cover it.
To start, your doctor will clean your face with alcohol and apply a topical numbing medication. Next, they’ll inject Botox into the muscles between your eyebrows, which contract when you frown. The Botox temporarily paralyzes them, making it difficult to frown.
Following the procedure, you’ll likely be able to return to your normal activities that same day.
The cosmetic effects of Botox last for about 12 to 16 weeks, but it’s mental health benefits may last longer than that.
Are there any side effects?
According to the Mayo Clinic, Botox is generally safe. However, you might notice some side effects after an injection, including:
- pain, swelling, or bruising near the injection site
- flu-like symptoms
- droopy eyebrow or eyelid
- dry eyes or increased tears
You may find these side effects more tolerable than those associated with antidepressants. These side effects can include:
- sexual dysfunction
- increased appetite
- weight gain
In rare cases, Botox can cause botulism-like symptoms in the hours or weeks after an injection. Contact your doctor right away if you notice:
- muscle weakness
- vision changes
- problems speaking or swallowing
- breathing difficulties
- loss of bladder control
- If you currently take medications for depression, don’t abruptly stop taking them if you decide to try Botox.
- Talk with your doctor to decide if discontinuing use of your antidepressant medications is right for you.
- If you decide to discontinue using your antidepressants, work closely with your doctor to slowly reduce your dose. This will help you avoid complications, such as withdrawal symptoms or worsening depression symptoms.
Depression is a common condition. The World Health Organization estimates more than 300 million people worldwide have depression.
While doctors are still in the earlier stages of determining exactly how it works, Botox injections appear to be a treatment option with relatively few side effects. However, many more large, long-term studies are needed. Talk to your doctor about whether or not it might be worth trying Botox to help treat your depression symptoms.