Botox to Treat Depression?


Can Botox treat depression?

We all know that Botox is expanding its realm for areas it can treat and improve, but can Botox really affect the mental as well as the physical? Botulinum toxin A appears to be effective at relieving depression, according to a systematic review and meta-analysis.

According to Ajay Parsaik, MD, of the University of Texas Health Science Center in Houston.  Botulinum toxin A prevents release of acetylcholine from nerve endings, which leads to muscle paralysis, he noted. The substance became a household name for its cosmetic role to treat frown lines. Then it expanded its uses to include treating muscle contractions or spasms, chronic migraine, and urinary incontinence in adults with multiple sclerosis and spinal cord injury, Parsaik said.

There are even studies being conducted that suggest the use of Botox in post-mastectomy breast reconstruction may reduce pain, and expedite tissue expansion.  And recently it has begun attracting attention as a possible treatment for depression, on the rationale that facial expression plays a role in mood so that preventing an unhappy expression might actually reduce unhappiness.

To examine the idea, Parsaik and colleagues looked for reports that compared the effect of botulinum and placebo injections in people with major depressive disorder. In the three randomized trials, response was defined as at least a 50% improvement in depression score in all three studies, while remission was defined as a primary depression score of no more than 10 in one study and no more than 7 in the other two. Parsaik and colleagues also calculated the number needed to treat for a response and a remission.

Overall, they found:

  • The mean difference in primary depression score between botulinum and placebo was 9.8 points, favoring botulinum.
  • For botulinum patients versus placebo patients, the odds ratio for a response was 8.3, with a 95% confidence interval from 3.4 to 20.3.
  • Similarly, the odds ratio for a remission was 4.6, with a 95% confidence interval from 1.6 to 13.1.
  • The number needed to treat for a response was 2.3, and 4.9 for a remission.

In both studies, the Beck Depression Index showed improvement after the injections, he said. The findings should be interpreted with caution, commented Julio Licinio, MD, of the South Australian Health and Medical Research Institute in Adelaide, Australia, who was not involved in the study but who said “A meta-analysis is only as good as the papers you find,” he told MedPage Today, and the limited amount of available research reduces the power of the study. “It’s a very preliminary finding,” he said, that is a “trigger for further study and investigation.”

But Licinio, who said he has studied depression for 20 years, says new treatments are clearly needed. “The problem, I think, in depression is that we do the same things over and over and over again, and there is nothing that is really a new concept.” Licinio said he has not employed the method, but added that for patients with refractory disease, botulinum toxin could be an option. “I think if someone is not responding to traditional treatment and you want to try something else that is not too harmful, it’s a possibility,” he said.

If you are seeking more information on facial and body reconstruction and plastic surgery you should make an appointment with a board certified plastic surgeon like Dr Aguiar. At Aguiar Plastic Surgery, we offer state-of-the art, safe, and effective cosmetic procedures, plastic surgery, reconstructive surgery, and Med Spa services in Tampa, Florida. We can discuss your concerns and give you an honest consultation that is designed and tailored to create an appearance on the outside that will reflect how you feel on the inside.

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