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Treating Depression With Botox

Pilot Study Says It Works, but Experts Critical.
WebMD Health News
Reviewed by Louise Chang, MD

May 16, 2006 – It is a treatment that brings new meaning to the phrase, "When you look good, you feel good."

Researchers say depressed female patients in a small, pilot study showed dramatic improvement when given Botox injections, with nine out of 10 no longer meeting the clinical standards for depression two months after the treatments.

But looking good actually had little to do with it, according to the Maryland dermatologist and cosmetic surgeon who led the study and hopes to patent a botulism treatment for depression.

Eric Finzi, MD, PhD, says the injections prevented the patients from frowning, which, in turn, helped to lift their depression.

"I think there is direct feedback between the facial frown muscles and the depression center of the brain," Finzi tells WebMD. "If you can prevent the negative signals that occur when someone frowns, the brain interprets this as meaning that things are better."

A Patient's Story

Kathleen Delano was skeptical when she entered the study. But after battling depression for more than 20 years, with conventional treatments offering little relief, she thought it was worth a try.

The 45-year-old marketing director and single mom tells WebMD that she gradually began to feel better after receiving the five injections that left her unable to frown.

"There was no dramatic cosmetic change, so that wasn't it," she says. "But I began to feel more like doing the things that I had been avoiding."

Delano says she soon began exercising more and re-established ties with friends. She also became more spiritually active.

"It is ironic that the very things that can help alleviate depression are the things that people want to do the least when they are depressed," she says, adding that she believes the Botox injection put her on the path to recovery.

Study Highly Flawed

The 10 female patients were recruited from Finzi's group dermatology practice, but none had been treated with Botox prior to entering the study.

All the women met the standards for ongoing major depression, based on their responses to standardized depression surveys. Seven of the 10 patients had tried one or more antidepressants, and four had been treated with psychotherapy.

Five Botox injections were given into the frown muscles (between the eyebrows) above the bridge of the nose, which had the effect of keeping the patients from frowning. Two months later, self-reported surveys indicated that nine of the 10 patients were no longer depressed, and the tenth had improved mood but was still depressed.

The study was published in the May issue of Dermatologic Surgery, the official journal of the American Society for Dermatologic Surgery (ASDS).

In an accompanying commentary, ASDS president-elect Alastair Carruthers, FRCPC, cited a series of flaws with the study and concluded that its finding must be considered anecdotal.

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