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Botox Injections May Ease Depression

A new study has found that Botox may be a treatment for depression.

Derived from a bacterial toxin, Botox is commonly injected to ease wrinkles, migraines, muscle spasms, excessive sweating and incontinence.

In the new study, researchers at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California San Diego discovered that people who received Botox injections reported depression significantly less often than patients undergoing different treatments for the same conditions.

The World Health Organization estimates that more than 264 million people worldwide experience depression. Depression is frequently treated with psychotherapy, selective serotonin reuptake inhibitors, dopamine-norepinephrine reuptake inhibitors and/or serotonin-norepinephrine reuptake inhibitors. But these approaches are ineffective for nearly one-third of patients.

That’s why clinicians and researchers are exploring other therapeutic options, including electroconvulsive therapy, transcranial magnetic stimulation, ketamine infusions and, more recently, Botox forehead injections.

“For years, clinicians have observed that Botox injected for cosmetic reasons seems to ease depression for their patients,” said Ruben Abagyan, Ph.D., a professor of pharmacy. “It’s been thought that easing severe frown lines in forehead region disrupts a feedback loop that reinforces negative emotions. But we’ve found here that the mechanism may be more complex, because it doesn’t really matter where the Botox is injected.”

Abagyan led the study with Tigran Makunts, Pharm.D., who was a pharmacy student at the time and is now a research fellow at the U.S. Food and Drug Administration (FDA), and Marc Axel Wollmer, M.D., a psychiatrist and researcher in Germany who has led past clinical studies in which Botox was found to alleviate depression.

The researchers examined the FDA’s Adverse Effect Reporting System (FAERS) database to see what nearly 40,000 people reported happened to them after receiving treatment with Botox for a variety of reasons.

The database contains more than 13 million voluntary reports of adverse effects people experienced while taking a medication.

Abagyan and his research team discovered they can also use the database to look for the absence of a health complaint when a person takes a medication. In this case, they searched for the absence of depression.

The team focused on nearly 40,000 FAERS reports of people experiencing adverse events after a Botox treatment. The reports cover Botox treatment for eight different reasons and injection sites, including forehead, neck, limbs, and bladder. Then the researchers applied a mathematical algorithm to look for statistically significant differences between Botox users and patients who received different treatments for the same conditions.

They discovered that depression was reported 40 to 88 percent less often by Botox-treated patients for six of the eight conditions and injection sites.

“This finding is exciting because it supports a new treatment to affect mood and fight depression, one of the common and dangerous mental illnesses — and it’s based on a very large body of statistical data, rather than limited-scale observations,” Makunts said.

The researchers note that the data used in the study was not collected for the purpose of exploring the association between Botox use and depression exclusively. In addition, the data represents only a subset of Botox users who experienced negative side effects.

While the researchers excluded reports in which a person was also taking antidepressants, the use of other prescription and over-the-counter medications could have been underreported in some cases, they added.

A clinical trial is now testing Botox treatment for people with depression through injections in the forehead, a gold standard approach for gathering insights on the relationship between a medication and a health condition, according to Abagyan.

Since that trial is only testing forehead injection of Botox, Abagyan said additional clinical trials may be necessary to work out the best site and dose to administer the medication specifically for the treatment of depression.

He added that more research is needed to determine the mechanism by which Botox acts as an antidepressant.

He and his collaborators hypothesize a few possibilities worth investigating: Botox could be transported to the regions of the central nervous systems involved in mood and emotions. Or, since Botox is commonly used to treat chronic conditions that may contribute to depression, its success in relieving the underlying problem may indirectly also relieve depression.

The study was published in Scientific Reports.

Source: University of California San Diego

Botox Injections May Ease Depression

Janice Wood

Janice Wood is a long-time writer and editor who began working at a daily newspaper before graduating from college. She has worked at a variety of newspapers, magazines and websites, covering everything from aviation to finance to healthcare.

APA Reference
Wood, J. (2020). Botox Injections May Ease Depression. Psych Central. Retrieved on November 23, 2020, from
Scientifically Reviewed
Last updated: 31 Jul 2020 (Originally: 1 Aug 2020)
Last reviewed: By a member of our scientific advisory board on 31 Jul 2020
Published on Psych All rights reserved.