Can Botox injections really ease depression? It may seem like an unlikely pairing, yet research looks promising.

If you’re living with depression, it may feel like a frustrating process of trial and error to unearth the right treatment, or combination of treatments, that work best for you.

It’s only natural to want to know about all your treatment options, particularly if you feel like traditional methods are falling a bit short.

If this sounds like you, you’re not alone. The rise of treatment-resistant depression has researchers exploring other alternatives.

It turns out, Botox may be a solid candidate.

Just like many people call tissues “Kleenex,” Botox has moved beyond a brand name to generally describe an injectable substance that tightens your skin.

In use since the 1970s, Botox comes from botulinum toxin A — a neurotoxin protein produced by the Clostridium botulinum bacteria.

Botulinum toxin A is offered under a handful of brand names. These include:

The injections work by blocking nerve signals to your facial muscles, which freeze them in place for 3 to 6 months. This may reduce the appearance of wrinkles, crow’s feet, and other lines from aging.

Along with cosmetic use, Botox has been granted FDA approval to treat:

Recent clinical trials have highlighted Botox as a safe, quick, and effective option for mitigating some symptoms of depression.

This is particularly true among women. A 2021 review found that Botox was more effective at treating major depressive disorder in women than men. Researchers note that Botox was less effective the more antidepressants someone was prescribed.

So far the research seems encouraging, but more studies are needed to determine exactly why Botox works for depression — that’s still a mystery.

One 2020 review notes a common theory is Darwin’s facial feedback hypothesis (yes, that Darwin), which suggests that your facial expressions can actually impact your emotional state. If you can’t frown with Botox, it’s thought that you won’t feel as down.

That same paper suggests that Botox may be able to block feedback between your nerves and the amygdala — the “fire alarm” in your brain that’s linked with fear, anxiety, anger, and depression.

Other experts believe the improved mood is tied to preserving your appearance, which may instill a sense of confidence and hope. One recent study found that self-reported feelings of depression dropped after Botox treatment and 1 month later.

Neurotransmitters may also be at play. A 2021 study suggests that Botox may alter your brain chemistry after an injection.

More specifically, it may supply a surge of 5-hydroxytryptophan (5-HTP) — the precursor to the “happy hormone” serotonin — as well as another key molecule related to cognition called brain-derived neurotrophic factor (BDNF).

Botox injections for depression are considered an “off-label” use, meaning they’re not yet approved by the FDA as a primary or complementary treatment option.

What does “off-label” use mean?

An off-label medication is one that hasn’t received FDA approval for a condition or symptom, but still may be effective for it.

According to the Agency for Healthcare Research and Quality, about 1 in 5 medications prescribed today (about 20%) are for off-label use.

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While there have been several positive reports, researchers still have many unanswered questions that make it difficult to regulate.

These include:

  • how effective it is
  • dosage
  • predictive factors for success
  • safety
  • underlying mechanisms for why it works

If you’re interested in trying Botox, it’s helpful to know what to expect ahead of time.

Finding a specialist

Botox is usually administered by a physician or nurse practitioner. It may vary, depending on what state you live in.

You may find it useful to explore this search tool and find a specialist near you.

Consultation appointment

At your first visit to a clinic, a specialist will work with you to listen to your concerns and make sure Botox treatment is appropriate for you. They will likely ask about your:

  • prescription medications
  • over-the-counter (OTC) medications
  • supplements
  • medical history
  • medical surgeries
  • elective procedures
  • pregnancy status

They’ll also answer any questions you may have, as well as review the possible risks and side effects.

Botox appointment

A Botox procedure usually takes between 15 and 20 minutes. Here’s the step-by-step process:

  1. A specialist confirms the areas you’d like to treat and how much Botox they’ll use.
  2. Treatment spots are marked on your face.
  3. Facial cleaner is applied before Botox is injected.
  4. Numbing cream or ice is applied to the areas where you’ll receive your injections, if you request it.
  5. A syringe filled with the medication will be injected into the muscles around your face, using a small needle, usually 1 to 3 times (depending on what you’ve agreed to).
  6. Ice and pressure is often applied after the injections to help reduce swelling.
  7. After the injection is complete, the specialist will provide you with aftercare instructions.

You can generally leave after the injections — there’s not a waiting period.


After you’re done with your Botox treatment, you can resume the rest of your day as you typically would.

For the most effective treatment and to prevent any complications, try to:

  • take a break from facial cleansers and makeup
  • avoid rubbing or touching the treatment areas
  • stay upright; do not lie down for at least 4 hours
  • avoid strenuous physical activity for 24 hours

Botox for depression is believed to be relatively safe, due to the low doses used for cosmetic treatment.

A review of 13 million reports on the FDA adverse event reporting system (FAERS) found that Botox and depression-related adverse events were less frequent than adverse event reports from other depression treatments, like antidepressants.

Side effects may include:

  • bruising
  • numbness
  • swelling
  • pain around the injection site
  • eye dryness and inflammation (xerophthalmia)
  • eyelid drooping (ectropion)
  • flu-like symptoms
  • headache
  • infection at the injection site
  • raised eyebrow(s)
  • in rare cases, allergic reactions like rashes or anaphylaxis

A 2019 study found that an upper respiratory infection was also a possible side effect.

A word of caution

In rare cases, the FDA says that the neurotoxin in Botox can spread beyond the injection site, which can lead to a potentially life threatening complication called botulism poisoning. The symptoms may appear within a few hours or weeks.

Some symptoms of botulism poisoning include:

  • trouble swallowing
  • muscle fatigue or weakness
  • drooping eyelids
  • vision changes such as blurry or double vision
  • trouble breathing
  • difficulty speaking

If you experience any of these symptoms, contact your physician immediately or call 911.

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Depression is different for everyone. There’s no cure-all.

For some people, therapy, medication, or a combination of both can have positive benefits. You may find it helpful to use our search tools to find a trusted mental health professional near you.

There are also several hotline numbers you can call for free and confidential support. In addition, the Anxiety & Depression Association of America (ADAA) offers online and in-person support groups.

If you want to explore beyond these options, you can learn about how to treat depression naturally.

If you’re curious about Botox and want to give it a try, you can find a specialist online or ask your primary care physician for a recommendation.

Keep in mind though that since Botox is not an FDA-approved treatment for depression, insurance may not cover it and some doctors might not even recommend it.