Botox May Help Bipolar Depression, Social Anxiety

SCOTTSDALE, Arizona — Botulinum toxin type A (BT), commonly known as Botox, may play a role in the treatment of bipolar depression and social anxiety disorder, preliminary research suggests.

In two small case series, injecting BT into the glabellar region of the face — the area between the eyebrows and above the nose — reduced symptoms of treatment-resistant bipolar depression as well as social anxiety. To read the full article, click here.

 

CBS News: Botox tested to help treat depression and social anxiety

While Botox is commonly used for cosmetic purposes, doctors say the reasoning behind the treatment for depression may not be what you expect.

“We don’t believe it has anything to do with looks,” says researcher Dr. Eric Finzi of Chevy Chase Cosmetic Center.

Rather, he says it’s because facial expressions are part of the circuit of the brain related to mood.

Could Social Anxiety Be Treated With BOTOX?

George Washington University in Washington, DC, is currently recruiting volunteers for a new study testing Botox to help symptoms of social anxiety.  

To see if you qualify for the free study, go to GWUanxiety.com

Social anxiety disorder (SAD), also known as social phobia, is a psychiatric condition affecting 12% of adults, approximately 20 million Americans, according to the National Comorbidity Survey Replication (NCS-R) (1) and noted by the National Institutes of Mental Health. SAD typically begins in the teenage years. The anxiety disorder is characterized by a high level of fear in social situations causing emotional distress and isolation, affecting work, community and romantic relationships. The George Washington University is currently recruiting volunteers for a new study testing the ability of botulinum toxin A, commonly known as Botox, to help symptoms of social anxiety. To see if one qualifies for this free study taking place at GWU in Washington, DC, go to www.GWUanxiety.com.

This pioneering research is being led by Eric Finzi, MD, PhD, the first to publish a study using Botox to treat depression (2), and Daniel Lieberman, MD, Professor of Psychiatry and Behavioral Sciences at The George Washington University School of Medicine & Health Sciences. This study is testing whether Botox injected into the frown muscles (the muscles that pull the eyebrows together to produce a worried look) will help with social anxiety as it does with depression.

“The same part of the brain involved in depression, the amygdala, is also involved in SAD (3,4),” explains Dr. Eric Finzi. “It is my hope this common and debilitating disorder, social anxiety, will be helped by Botox treatment,” he adds.

Dr. Lieberman notes, “Although Botox is used primarily for cosmetic purposes, its effect on anxiety and depression have nothing to do with changes in appearance. It seems that paralyzing the frown muscles actually quiets down a part of the brain that amplifies negative emotions (5).” Social anxiety is a debilitating illness that often goes untreated. It is common for some sufferers to self-medicate with alcohol or other drugs to reduce fears at social events. If undiagnosed or untreated, social anxiety can lead to alcoholism, eating disorders or other kinds of substance abuse.

One of the more effective ways to treat social anxiety is with cognitive behavioral therapy (CBT). However, it is time consuming and it can be difficult to find a therapist with the proper training. Physicians often prescribe antidepressants, but more than half fail to respond adequately (6). In addition, antidepressant’s side effects may cause other unwanted health issues for users. Botox has a very favorable side effect profile, and has been in use for more than twenty years.

In 2014, Eric Finzi, MD, PhD and psychiatrist Norman E. Rosenthal, MD, Clinical Professor of Psychiatry at Georgetown Medical School, published the largest randomized, double-blind, placebo controlled trial on the effect of Botox on depression (7). They found that more than half of subjects suffering from moderate to severe depression showed a substantial improvement (greater than or equal to a 50% reduction in depressive symptoms) as measured by the MADRS, a standard depression scale. The study showed that Botox may help relieve depression both by itself as well when it is added to boost other treatments. There have been two other randomized controlled trials showing the effectiveness of Botox to treat depression, with similar results (8). Clinical trials are currently underway to get FDA approval for this novel treatment.

Persons interested in more information and to see if they qualify as a volunteer for this experimental treatment of social anxiety, can go to www.GWUanxiey.com. For more information about Botox to treat depression, go to www.BotoxForDepression.com.

MEDIA INQUIRIES CONTACT: Michelle Delino (202) 486-7622 or by email: contact@michelledelinomedia.com

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Resources:
1. Kessler, Ronald C., et al. “Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.” Archives of general psychiatry 62.6 (2005): 593-602.
2. Finzi, Eric, and Erika Wasserman. “Treatment of depression with botulinum toxin A: a case series.” Dermatologic Surgery 32.5 (2006): 645-650.
3. Labuschagne, Izelle, et al. “Oxytocin Attenuates Amygdala Reactivity to Fear in Generalized Social Anxiety Disorder.” Neuropsychopharmacology 35 (2010): 2403- 2413.
4. Victor, Teresa A., et al. “Relationship between amygdala responses to masked faces and mood state and treatment in major depressive disorder.” Archives of general psychiatry 67.11 (2010): 1128-1138.
5. Kim, M. Justin, et al. “Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an ABA design.” (2014).
6. Trivedi, Madhukar H., et al. “Evaluation of outcomes with citalopram for depression using measurement-based care in STAR* D: implications for clinical practice.” American journal of Psychiatry 163.1 (2006): 28-40.
7. Finzi, Eric, and Norman E. Rosenthal. “Treatment of depression with onabotulinumtoxinA: a randomized, double-blind, placebo controlled trial.” Journal of psychiatric research 52 (2014): 1-6.
8. Magid, M., et al. “Treating depression with botulinum toxin: a pooled analysis of randomized controlled trials.” Pharmacopsychiatry 25.06 (2015): 205-210.

BuzzFeed News on Possible Treatments for Depression

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Botox, Cough Syrup, And An Anesthetic Are All Being Tested As Antidepressants

Pharma companies are looking at old drugs — including a common cough suppressant, an opiate addiction treatment, and even Botox — for new ways to treat depression.

Despite the dozens of prescription drugs on the market for treating depression, up to half of depressed people can’t find relief.

That’s an enormous market opportunity: millions of people who need daily treatment for a chronic condition. But after years of expensive failures trying to develop new antidepressants from scratch, many companies have largely lost interest. Read More

 

Science of Smiling in HuffPost Healthy Living

Dr. Eric Finzi and Dr. Norman Rosenthal’s research study findings featured in The Science of Smiling by Andrew Merle for Huffington Post Healthy Living

When we are happy, our natural response is to smile. But if you flip that around, does the reverse hold true? When we smile, is our natural response then to be happy?

Science says yes.

In fact, even faking or forcing a smile reduces stress and makes you happier….

…Another study looked at the effect of facial expression on depression. The experimenters, Eric Finzi (cosmetic dermatologist) and Norman Rosenthal (professor of psychiatry at Georgetown Medical School) worked with 74 subjects who all had major depression, and either gave them a Botox injection between the eyebrows that prevented frowning, or a placebo saline injection that did not affect the facial muscles.

The findings showed that, six weeks after the injection, 52 percent of the non-frowning Botox group showed a reduction in their depression, compared to only a 15 percent improvement rate for the placebo group. The results indicate that putting on a happy face actually makes you happier.

It seems that the simple act of a physical smile, authentic or not, tricks your brain into thinking you’re actually happy. Smiling also triggers us to think back to joyful memories, further improving mood.

In addition to lifting mood and reducing stress, other research has shown that people who smile are thought to be more friendly and likeable, and smiling actually makes those around you cheerier as well.

All of this shows that the old sayings actually deliver great advice — it’s time to turn that frown upside down, grin and bear it, and say cheese!

LINK to Article

Botox for Depression, Eric Finz, Faces of Emotion

 

For more insight in to the study findings READ Dr. Eric Finzi’s Book, Face of Emotion: How Botox Affects Our Mood and Relationships

 

New Botox for Depression Research Published in Pharmacopsychiatry

Treating Depression with Botulinum Toxin: A Pooled Analysis of Randomized Controlled Trials

Abstract

Introduction: Botulinum toxin A (BTA) injection into the glabellar region is currently being studied as a treatment for major depressive disorder (MDD). Here we explore efficacy data of this novel approach in a pooled analysis.

Methods: A literature search revealed 3 RCTs on this topic. Individual patient data and clinical end points shared by these 3 trials were pooled and analyzed as one study (n=134) using multiple regression models with random effects.

Results: In the pooled sample, the BTA (n=59) and the placebo group (n=75) did not differ in the baseline variables. Efficacy outcomes revealed BTA superiority over placebo: Improvement in the Hamilton Depression Rating Scale or Montgomery-Asberg Depression Rating Scale 6 weeks after baseline was 45.7% for BTA vs. 14.6% for placebo (p<0.0001), corresponding to a BTA response rate of 54.2% (vs. 10.7%) and a BTA remission rate of 30.5% (vs. 6.7%).

Discussion: Equalling the status of a meta-analysis, this study increases evidence that a single treatment of BTA into the glabellar region can reduce symptoms of MDD. Further studies are needed to better understand how BTA exerts its mood-lifting effect.  Read More…

 

 

Forbes Magazine “Botox Seems To Ease Depression”

Forbes.com’s Matthew Herper, a reporter on the Pharma and Healthcare beat, covered the recent annual meeting of the American Psychiatric Association in Toronto and wrote about the collective data findings on Botox to treat depression. Herper writes, “the analysis of the data published so far presented here at the American Psychiatric Association in Toronto seem to support the idea that Botox injections in the face can ease depressed mood.” Read more.