Finding a Botox doctor who will administer for treatment-resistant depression?

Botox in the glabella has been used for treatment-resistant depression (See Finzi; Magid; Wollmer). Allergan is conducting Phase II trials but right now it is an off-label use and many doctors haven't heard of it. How can a patient find a doctor willing to administer Botox for depression?

Doctor Answers 9

Finding a Doctor who is willing to go off label?

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My advice would be to ask the doctor who is treating your depression if they know someone who is willing to try this. At least your doctor will have an opinion based on what they have tried. 
PS I have not personally ever given Botox for anything other than relaxing facial muscles. 
I have alot of patients who are very happy with the results but that is NOT the same thing as treating depression!

Silver Spring Dermatologic Surgeon

Finding a Botox doctor who will administer for treatment-resistant depression?

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Thank you for your question.  As the glabella is one of the top 2 areas to receive Botox most physicians providing Botox services will be able to administer it for you for depression.  Unfortunately it will take a long time before insurance companies will cover the cost for you, if it all.  Hope this helps. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 79 reviews

Finding a Botox doctor who will administer for treatment-resistant depression?

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Botox is not currently indicated for the treatment of depression.  Phase II trials means that a small subset of patients with depression are receiving the drug to determine if there is a benefit. This is before stage III trials where the treatment is given to a large population of patients to see if there is a benefit and what the risks are.  This is before FDA approval.  Given all of that, to be used for depression would certainly be an off label use.  This would not be covered by insurance.  You could try using it for cosmetic purposes and see if it helps, but it would be important to realize that the purpose of the Botox would not be to treat depression but rather the cosmetic purpose.  If you then got an improvement for depression that would be a benefit.

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

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Botox for depression

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I think, until better data is available, many doctors who administer Botox for frown lines (esthetic physicians such as cosmetic dermatologists and plastic surgeons) are unconvinced of the initial reports of Botox being useful for "treatment-resistant" depression. Larger studies (page 3) will help to clarify the benefit of Botox. I wonder if your psychiatrist thinks that Botox will help you...In the meanwhile, you can try contacting Dr. Eric Finzi in Maryland, a former colleague of mine and a very smart physician. You could Google him and ask about his current opinion on the topic and whether insurance covers it at all. I would highly doubt that insurance will cover it without further confirmatory studies by psychiatrists ( may be the Allergan studies involve psychiatrists). As long as you're not looking to have your Botox treatment submitted to insurance, many esthetic physicians will probably be willing to treat the glabellar (frown) creases for you. You will then have to co-ordinate with your psychiatrist to manage your anti-depressant medications as needed. Injecting Botox for off-label use is common place and frequently done by most esthetic physicians for esthetic reasons beyond the FDA-approved indications.I hope this helps. Thanks you for raising an interesting question.

Renuka Diwan, MD
Cleveland Dermatologic Surgeon

Cosmetic Botox to treat depression?

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It is well known that patients feel better when they get Botox and the study only confirms that because your self image improves relatively quickly.

Well worth the $200 to terat depression! 


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My guess is you are hoping for insurance to pay for your injection?  Interestingly, we are often finding new uses for Botox to treat various medical conditions.  Treatment must undergo rigorous scientific study prior to FDA approval.  Insurance will likely not pay for the treatment unless it is FDA approved.  But, you can still pay out of pocket for Botox cosmetic to the glabella, which is relatively inexpensive if this is the only area you are having injected.  
Best wishes

Daniel J. Givens, MD
Dubuque Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Botox for depression

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I dont understand why you would need to have the Botox administered "for depression"? is it important for you that the doctor know you have depression? why not just have cosmetic Botox injected in your Glabella which is routine for cosmetic purposes and if you get psychiatric benefits, then even better.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon

Botox injections in glabella for depression

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Thank you for sharing your question. Botox is easily administered in the glabella region by an experienced injector. Unfortunately, it will not be covered by insurance at this time. I hope you feel better.
Good luck,

Botox and Depression

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Many doctors administer Botox but it is not covered under medical insurance for depression.  You can consult a cosmetic dermatologist for Botox and see if it helps your depression.  Best, Dr. Green

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.