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Editorials

What? Botox injections can mitigate depressions?

May 17, 2022

Steven Lippmann, M.D.  

“Botox”, or botulinum toxin, has long had popular cosmetic use at smoothing facial wrinkles.  It is also prescribed for pathologies, mostly of neuromuscular origins, like in pain syndromes and/or muscular spam cases. Many people like and benefit from the results.

Researchers began noticing that injecting extracts from the bacterium Clostridium botulinum into the glabella muscles seemed to improve mood. They wondered if facial injections into these tissues might even attenuate affective disorders. After observing the positive emotional outlook among some individuals receiving glabellar botox for a variety of medical indications, investigators focused on psychiatrically assessing whether botox is an independent mood elevator.

Fewer wrinkles may improve self-concept and that might elevate spirits. The new contention additionally suggests that facial botox shots induce neurochemical influences that physiologically mitigate depressive illnesses. They might even help people gain a more positive mental outlook despite treatment-resistant depressions.

This neurotoxin inhibits acetylcholine release at the neuromuscular junction and temporarily paralyzes affected muscles. Perhaps paralysis of glabellar musculature provides central nervous system feedback to attenuate excessive cholinergic stimulation during a depression. Maybe it works like the feedback mechanism of vagal nerve stimulation and/or other similar means of indirectly-yet-centrally affecting brain function. There is no known contraindication to giving botox injections while co-prescribing antidepressant drugs, psychotherapy, or other interventions. Details are unknown, but botox injections remain interesting and are worthy of consideration as a means of helping selected patients with mood disorders.

Suggested readings

  1. Coles NA, Larsen JT. Kuribayash J, Kuelz A. (2019). Does Blocking Facial Feedback Via Botulinum Toxin Injections Decrease Depression? A Critical Review and Meta-Analysis. Emotion Review, 11(4), 294–309. https://doi.org/10.1177/1754073919868762. Accessed in May 2022.
  2. Finzi E, Wasserman E. (2006). Treatment of Depression with Botulinum Toxin A: A Case Series. Dermatologic Surgery, 32(5), 645–650. https://doi.org/10.1111/j.1524-4725.2006.32136.x. Accessed in May 2022.
  3. Qian H, Shao F, Lenahan C., et al. (2020). Efficacy and Safety of Botulinum Toxin vs. Placebo in Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Psychiatry, 11, 603087. https://doi.org/10.3389/fpsyt.2020.603087. Accessed in May 2022.
  4. Risch SC, Cohen RM, Janowsky D S, et al. (1980). Mood and behavioral effects of physostigmine on humans are accompanied by elevations in plasma beta-endorphin and cortisol. Science (New York, N.Y.), 209(4464), 1545–1546. https://doi.org/10.1126/science.7433977. Accessed in May 2022.

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‹ Suicidal ideation in depressed patients with or without comorbid posttraumatic stress disorder treated with selective serotonin reuptake inhibitors › Fluvoxamine attenuates COVID-19 disease

Editorials

  • Monkeypox: A psychiatrist’s guide
  • Fluvoxamine attenuates COVID-19 disease
  • What? Botox injections can mitigate depressions?
  • Smoking, suicide risk, and the COVID-19 pandemic

Research Papers

  • COVID-19 mortality in Europe and the ’Iron Curtain’ between East and West
  • Examination of depressive signs and symptoms among 803 University students in seven Universities and Colleges. Hungary, Romania, Serbia.
  • Examination of spirituality and the dimensions of spirituality among 803 students in seven different Universities. Hungary, Romania and Serbia.
  • Examination of depressive signs and symptoms among 932 students in eight different secondary schools in Hungary

Research News

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Latest News

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Interviews with eminent psychiatrists

  • Interview with Professor Shih-Ku Lin
  • Interview with Professor Masahito Fushimi
  • Interview with Professor Maurizio Pompili
  • Interview with Professor Marco Sarchiapone

Ten Years Ago

  • Teaching medical professionals and trainees about suicide prevention
  • Suicidal ideation in depressed patients with or without comorbid posttraumatic stress disorder treated with selective serotonin reuptake inhibitors
  • Treatment of suicide attempters with bipolar disorder: a randomized clinical trial
  • Posttraumatic stress disorder and the Neuroevolutionary Time-depth Principle

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