Botulinum toxin injections improve depression

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At the American Academy of Dermatology (AAD) 72nd Annual Meeting, presented March 22, 2014, clinical associate professor of psychiatry at the University of Texas Southwestern in Austin and Allergan consultant (makers of Botox), Michelle Magid, MD presented research suggesting botox (botulinum toxin) injections improved symptoms of depression, even after the forehead wrinkles returned.  The researchers were encouraged by this particular finding, suggesting that the anti-depressant effect isn’t just related to the cosmetic improvement of erasing wrinkles.  Skeptics point out that although the study is interesting, the results are complicated because the subjects were able to see the cosmetic improvement from the botox injections.

Dr. Magid explained to Medscape Medical News that two possible reasons exist for the improvement in depressive symptoms.  “The first is that the botulinum injections made it difficult for the subjects to frown. If individuals smile more and frown less, they are likely to have better social experiences, which could lift mood. The second possibility, favored by Dr. Magid, is a biologic explanation. MRI studies have shown that when people are unable to make angry facial expressions because of botulinum injections to the glabellar region, there is less activity in the amygdala than expected. Such a connection could be mediated by the trigeminal nerve, which links the glabellar region to the brain stem and amygdala and is the control center of anxiety, trauma, and the heightened fear response. If a person can’t frown, the brain does not register a frown, and the amygdala does not get the trigger that the person is upset”.  It is interesting to note that patients with depression and anxiety were affected more significantly than those with strictly melancholic depression.  Read the entire article written by Jim Kling for Medscape Medical News here.