Botox Could Treat Depression — No, Really

IMG_0097_r_JessicaNash PAGPhotographed by Jessica Nash.
Depression is one of the most common mental illnesses in the U.S. — it affects an estimated 10% of the population. But, a few studies suggest that a new treatment for depression could come from an unlikely source: Botox.
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The most recent of these studies, published last month in the Journal of Clinical Psychiatry, looked at the effects of onabotulinumtoxinA (BTA, the generic name for Botox) or saline injections in 30 participants, both male and female, who were all between the ages of 18 and 65 and had been suffering from major depressive disorder for at least six months. After 24 weeks of injections delivered directly to the "frown muscles," the group that had gotten BTA showed significant improvement of their depression symptoms using several different self-reported scales and questionnaires. The researchers propose that this could be due to a sort of "smile and you'll be happy" effect that's been studied for decades, and which Botox has been linked to before. Interestingly, the groups switched conditions in the middle of the experiment (those who were getting BTA started getting saline instead and vice versa). So, the effects of the BTA injections lasted beyond the period during which the BTA would have been actually causing any paralysis.
In another study, this one published in May in the Journal of Psychiatric Research, 74 participants with major depression were given BTA or saline injections over the course of six weeks. The researchers here found similar results: Those receiving BTA injections showed significant improvement compared to those receiving the placebo. These results confirmed those of another previous study from 2012; the two researchers who conducted that one have even taken the extra step of creating BotoxForDepression.com. It's certainly not every day that a scientific concept gets its own URL.
But, these are just a few studies with relatively small samples sizes. And, as has been noted elsewhere, it would probably be pretty difficult to maintain a truly blinded study of the effects of Botox (in which participants wouldn't know whether they had gotten saline or the real deal). And, the logic behind the effects described in these studies — namely that changes in facial expression can improve one's mood — has been criticized as an oversimplification of a complex illness.
These studies also only looked at BTA compared to a placebo, so we can't say anything about its effectiveness compared to currently available antidepressants. But, there's definitely a need for depression treatments that work quickly, without the need for long-term commitment, and without as many serious side effects as the prescription options we have now. So, the potential demand for treatments based on this research — as well as those done with ketamine or MDMA, the other current headline favorites — is huge. But, whether or not Botox is actually a viable therapy option remains to be seen. Because, really, the last thing anyone wants to be told when they're depressed is to "just cheer up and smile!"
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