Do antidepressant drugs interfere with the effects of Botox?

Antidepressants should have no effect on the duration of Botox so it might be a good idea to seek a second opinion

Thank you for your question pepita84. I understand your concern. Botox is a purified protein
used to address wrinkles associated with facial expression. When injected into
the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The
most common areas of treatment are in the upper face. These include the
horizontal lines seen on the upper forehead when one raises the brows, the
vertical lines seen between the brows when one frowns (frown lines), and the
crow's feet seen around the eyes when one smiles.
The appearance of frown lines is variable from
person to person. Usually they are in a vertical orientation but sometimes they
can be oblique and sometimes a horizontal line is seen across the upper portion
of the nasal bridge. The most common variation is to have two parallel lines,
hence the common term "11's" to describe them. But some people have
one, three, or more lines. Some people also will see a bulge in the area when
contracting the muscle. This bulge is smoothened out after a Botox treatment.
The pivotal studies used 20 units of Botox in
the glabella area between the brow to address the frown lines. These studies
demonstrated that the peak results are seen 14 days after the treatment and
most people enjoy their results for 3-4 months. At that point, a maintenance
treatment is recommended. While some people start to see results as early as
the next day, it can take two weeks for full results so patience is
important. We have our patients return two weeks after their treatment to
assess their results via photographs. At that time additional units may be
added if necessary.
There have not been such studies published for
the horizontal lines on the upper forehead. However, in my experience I find
that 10-20 units works well in this area. For patients with narrow foreheads a
lower dose may be used and those with a broad forehead generally require higher
doses. I have also found that the full results in this area are seen by two weeks.
Therefore, we have our patients return two weeks after their treatment to
assess the results via photographs. At that point additional units may be used
if further enhancement is desired.
While Botox is one of the safest treatments
offered, there are some situations where it is not appropriate. These include
anyone who has an allergy to any of the inactive ingredients or who has had an
allergic reaction to any botulinum product including Botox, Dysport, Xeomin, or
Myobloc. The safety and efficacy of Botox has not been established in women who
are pregnant, trying to become pregnant, or breast feeding. Therefore, women in
these categories are advised to wait until breast feeding is completed prior to
having a Botox treatment. Botox should not be placed in the skin on the site of
an infection. Those who are taking an
aminoglycoside antibiotic, an anesthetic, D-penicillamine, antimalarials, or
immunosuppressants should not be treated, nor should those who have undergone
chemotherapy within the previous six months. The use of antidepressant medications is not a contraindication to Botox treatment. It is important to avoid blood
thinners before and after a treatment. These include both prescription and
non-prescription medications such as warfarin (coumadin), aspirin, ibuprofen,
alcohol, fish oil, vitamin E, and ginko biloba. Those with conditions that affect
muscles and nerves such as amyotrophic lateral sclerosis (ALS or Lou
Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome should not
undergo Botox treatments.
In rare cases, some people are resistant to a
certain neuromodulator such as Botox. In this case the treatment can be
repeated using a different neuromodulator such as Dysport or Xeomin.
With any injection, there are risks such as
pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take
special precautions to minimize these risks such as using a painless technique.
We also treat bruises with a laser as early as the next day. Bruises usually
resolve within two weeks if untreated. After a laser treatment bruises usually
resolve in 1-3 days, but may still take two weeks for full resolution. In
addition to these risks, with Botox there is also a risk that the product spreads
or diffuses to nearby structures. Spread to nearby muscles can lead to side
effects such as the temporary appearance of droopy eyelids or a temporary
asymmetric smile.
After a Botox treatment, I recommend that my
patients avoid heat exposure, alcohol consumption, and strenuous exercise for
24 hours and not lie down flat for four hours. This is because all of these
activities may possibly lead to the movement of the product and consequent side
effects such as droopy eyelids as described above. Although there have been no
definitive studies shown that these actually occur and some physicians do not
provide such aftercare instructions, in the absence of data I err on the side
of caution and recommend that my patients avoid such activities.
Please consult with a doctor for specific
recommendations. Good luck!