Is It True That Botox Can Help with Depression and Bipolar Disorder?

I know that botox can be used to treat migraines, but I recently read that it can be used to help depression. Is that correct. I am bipolar, and the medication I take controls the highs really well, but I still have bouts of depression, although not as overwhelming as before. Can botox really help depression, or it just an excuse to have botox injected, and reap the cosmetic benefits under the guise of medical necessity?

Doctor Answers 12

Botox for Depression

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I wrote an article published in Drugs in Dermatology comparing the costs and benefits of Botox for Depression.

Although the data is limited, what is available suggests that Botox helps people with moderate depression.

More research is indicated to try to determine who the treatments would benefit and how/ if they work or whether the initial observations are accurate.

For some people, any cosmetic intervention helps them look and feel better and treatment with Botox may help these people feel better

attached is the abstract from the article

J Drugs Dermatol. 2010 Jan;9(1):27-30.
Cost effectiveness of botulinum toxins for the treatment of depression: preliminary observations.
Beer K.
SourceEsthetic, Surgical and General Dermatology Center, West Palm Beach, FL, USA.

The standard of care for the treatment of depression involves pharmacologic therapy with selective serotonin reuptake inhibitors (SSRIs). Cognitive therapy is typically utilized in addition to a pharmacologic intervention. However, the benefits of the drugs used may be marginal compared with placebo yet the costs associated with their use continue to increase. One potential treatment for depression utilizes botulinum toxins. At the present time there is a small body of evidence supporting their use for depression, the potential efficacy and cost effectiveness of this treatment warrants further consideration including head to head clinical trials.

PMID:20120422[PubMed - indexed for MEDLINE] 

Palm Beach Dermatologic Surgeon

Botox: Fascinating idea, but unknown if useful for depression / bipolar

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This is a fascinating question and I think the answer is we just don't know right now. That having been said I have heard from a psychiatrist friend that there is at least one clinical study underway looking at botox as add-on therapy for depression that is resistant to conventional therapy. The important things to focus on here are that 1) this study is ongoing, and is not proof that botox helps depression or bipolar disorder and 2) even if botox does turn out to be useful in this regard, it will only be used in addition to conventional FDA approved medications. Nobody is even suggesting that botox could be used by itself to treat these conditions. However, if a person who is on conventional FDA approved medications for depression or bipolar were to purchase botox injections it is possible that they might be helpful. That is a lot of maybes. Still, it is a fascinating question as to whether stopping negative facial expressions with botox can reduce negative feelings in the brain. Stay tuned!

Daniel J. Ladd Jr., DO
Austin Dermatologist

Botox can improve your appearance in a very natural way

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A very small study published in 2006 showed that Botox improved symptoms of depression in 9 of the 10 patients who had injection for the "frown lines" between the eyes. We know that emotions are closely tied to facial expression and that we feel a little happier just by performing the act of smiling. However depression is due to a chemical imbalance and it is very unlikely that Botox injections alone will cure this condition. It has not been shown to have any effect on bipolar disorder.

The thinking was that by not being able to furrow the brows or frown may help reduce the associated negative or depressive symptoms. However, it was a very small study and further studies are needed to show if this is a true effect. It is not recommended or FDA approved to treat depression with Botox and even if the injections helped, they would most likely need to be used along with other medications and treatments to effectively control this medical condition.

Doris Day, MD
New York Dermatologic Surgeon

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There is no evidence that BOTOX® is useful for the treatment of depression or bipolar disorder.

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I have just finished writing a chapter for a medical textbook on the effects of BOTOX® and other formulations of BTX-A on mood and perception.

Bottom line: treatment with BOTOX® can [to a limited extent] improve mood and self esteem in many normal people, and in some cases can [to a limited extent] improve their ability to understand the feelings of others.

I am not aware of any evidence that treatment with BTX-A will be helpful [or harmful] in people who have depression and/or bipolar disorder.

Mood quite often improves in many headache patients [as you would expect] when the burden of headache is reduced or eliminated by treatment with BTX-A, either directly and/or by a reduction in their consumption of headache medications [for example, NSAIDs, triptans and narcotics].

Kevin C. Smith, MD
Niagara Falls Dermatologic Surgeon

Don't Use Botox for Depression

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I do not recommend Botox for depression.  If you also have cosmetic areas to treat, then go ahead, but don't expect an anti-depressant effect.

Why not try a nutritional psychiatrist (you can find names online) who can help you nutritional and via supplements with the depression you are experiencing.  You may be experiencing side effects of the medication itself.

Lisa Benest, MD
Burbank Dermatologist

Don't count on it

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Botox does a lot of good things.  Depression is a serious problem that is not treated with Botox.

Any good feeling you get from Botox is going to be temporary.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

Consult with Psychiatrist before having Botox

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IMHO, you should discuss this with your psychiatrist before having any Botox as a therapy for your bipolor disorder.

Botox may improve mood but won't treat depression

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There is some evidence that Botulinum (Botox) injections may improve mood and feelings of stress. The theory is that part of the emotional experience of stress is expressing it through facial muscles, especially the ones that cause the furrows between the eyebrows (which is where Botox is placed.) By relaxing those muscles with Botox, the feedback loop is interrupted and mood improves. However, treatment of depression and bipolar disorder is an entirely different matter.

Depression or bipolar treatment with botox?

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psychiatric disorders in the depression/bipolar family are generally related to deficincies in the neurotransmitter called serotonin among others. Botox decreases the uptake of acytlcholine at the neuromuscular junction. this is not related to serotonon in the brain. I am not aware of any data pertaining to a treatment of depression with botox. definitely a question for your psychiatrist. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

BOTOX is not a treatment for depress or bipolar disorder.

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There is clinical evidence that botox can make people feel better but the effect is very subtle.  There is no evidence that this effect can be used to treatment clinical depression or bipolar disorder.  It would be a mistake to interpret these very interesting studies as showing botox is a treatment for clinical depression.  

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
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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.