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Botox injections may have relieved depression



Doctors inject Botox to smooth out facial wrinkles and treat health problems such as heavy sweating, uncontrollable blinking, chronic migraines, overactive bladders and neurological disorders that cause muscle contractions and neck and shoulder pain.

Botox, a medicine made from a toxin produced by the bacterium Clostridium botulinum, works by weakening or paralyzing specific muscles or blocking certain nerves.
More than 264 million people worldwide suffer from depression. For nearly a third of these people, conventional treatment for depression is not effective, even if they follow their treatment plans and tolerate the medication, according to a study published in the journal Scientific Reports on Thursday.
This deficiency has prompted doctors to explore alternative therapies, such as doses of psilocybin (the active substance in psychedelic mushrooms), ketamine infusions and, more recently, Botox injections. Previous studies over the past 1
5 years have found that the drug may contain antidepressants.
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It is unclear how and for how long the treatment will last for depression, but researchers thought Botox could disrupt the feedback between negative facial expressions in the glabellar area – behind the skin between the eyebrows and above the nose, where our “grief muscles” contain negative emotions. Because of this hypothesis, those studies mainly used forehead injections to treat depression, but their sample size, unstable methodology, injection sites, and different outcomes were limited.

Botox for a variety of conditions

To address the limitations of previous studies, the researchers analyzed more than 45,000 adverse event reports related to Botox treatment from the U.S. Food and Drug Administration’s Adverse Event Reporting System. The system supports the monitoring of adverse drug reactions reported to the FDA by patients, healthcare professionals, and drug manufacturers through the FDA’s safety information and adverse event reporting program, MedWatch.
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They divided the patients into eight groups, corresponding to the medical symptoms most commonly treated with Botox. These were:

  • cosmetics for wrinkles, facial skin, skin fillers or other preparations
  • migraine
  • spasms or cramps in the extremities (when the muscles become stiff or tense and prevent you from moving, talking and walking)
  • neck pain
  • involuntary blinking or cramps in their eyelids
  • excessive sweating
  • excessive dusting
  • neurological and bladder disorders

Each cohort was divided into two groups, with one group receiving Botox for their conditions and the other not. Patients who received injections of Botox to treat heavy sweating, facial wrinkles, migraines, spasms, and spasms experienced depression 40 to 88% less often than people who were treated differently for the same conditions.

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“We found that (effects) did not depend on the injection site and (medical condition), which are very different from Botox,” said Ruben Abagyan, lead author and professor at the University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences.

“The consequences are fascinating because it means that depression can be cured in different ways (not necessarily), not necessarily by injection into one of the facial muscles, which can be undesirable in some cases,” Abagyan added.

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Although the facial feedback hypothesis is a “reliable and reasonable mechanism,” the study says, the findings may suggest that there are other, more sophisticated ways in which Botox can have antidepressant effects.

Botox can be transferred to the structures of the central nervous system, which are involved in the regulation of our moods and emotions. 2019 The study found that Botox injections for muscle spasms can cross the injection site and affect opposing muscle groups and reflexes through changes in nerve activity.

“Part of that goes into the systemic distribution through the blood … and then somehow gets into the brain and can affect different places,” which may be related to depression, Abagyan said.

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The interaction between muscles and mood is not limited to the process of facial feedback.

Muscle tension in various regions of the body is a common symptom of depression and can be both a physical manifestation of the disorder and an increase in depressed mood. This is why progressive muscle relaxation, which mentally relaxes a person by stretching and relaxing their muscles, is a well-established treatment in the field of psychiatry.
Depression is associated with increased muscle tone, which characterizes the maintenance of partial muscle contraction. The decrease in muscle tone due to Botox injections, which weakens the muscles, can neutralize depression.

“Imagine that when you feel depressed, not only does one area of ​​your forehead make up this wrinkle, but all your muscles experience stress and narrowing,” Abagyan said. “Then the muscle memory is distributed. By breaking that memory, essentially releasing them all, in which case you shrink the feedback between the head and the muscles.”

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Because some of these diseases are chronic and aggravating, they can cause secondary mental problems such as depression. If Botox solved these problems, it could have alleviated depression.

“This study raises the question of whether muscle spasms or sweating can also cause a physical feeling of depression, and by treating this ‘feeling of depression’ we can affect not only the patient’s medical problem (but) and his psychological well-being. “, – el. Dr. Jason Reichenberg, a dermatologist at Ascension Medical Group and a professor of internal medicine at the University of Texas at Austin, said in a letter. Reichenberg did not participate in the study.

The future of Botox

Because the FDA reporting system is voluntary and open to the public, adverse reactions to Botox may have been under-reported and biased, the study said. Other information on demographics, treatment doses and duration, medical records, and other medications or supplements was also limited.

Research on past data cannot establish a “cause-and-effect relationship,” but it helps us focus our research on the future, ”Reichenberg said. “The results are even more impressive when you realize that the authors excluded all patients who took antidepressants so as not to be biased; their results could have been even stronger if they had kept those other data.”

The researchers suggested that Botox injections could be an alternative treatment for those who fail with conventional treatments for depression, as well as for those who suffer from both chronic illnesses and depression.

“If someone needs treatment for excessive salivation, cramps, or tilted head and they are depressed at the same time, the discovery suggests that (Botox) may be beneficial in both indications,” Abagyan said. “If you can kill two birds with one stone, I think that really needs to be taken into account.”

Abagyan says depression carries risks such as the risk of suicide, but also Botox injections if the doses are disproportionate to the patients. Additional research into Botox treatment for depression is needed to understand potential side effects and ensure a safe path to mental health.


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