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Could Botox cure depression?
A single injection of Onabotulinumtoxin A, better known as Botox, significantly reduces depressive symptoms in patients with major depression. This effect may be linked to the proposed association between facial expression and mood. These are the major findings of a new study to be published in the May 2014 edition of the Journal of Psychiatric Research.

In the largest study to consider the effect of Botox on depression, 74 subjects with DSM-IV major depression were randomly divided to receive a single injection of either Botox or placebo into the corrugator and procerus frown muscles in the forehead. The Montgomery–Asberg Depression Rating Scale (MADRS) was administered at the start of treatment and after three weeks and six weeks. The primary outcome measured in the study was ≥ 50% reduction in MADRS score. After six weeks, the results showed that there was a response rate of 52% in the Botox-treated group compared to only 15% in the placebo group; this was a significant difference. Also, in a secondary outcome measure of remission rate, assessed by a MADRS score of 10 or less, the results were 27% for the Botox-treated subjects as opposed to only 7% in the placebo group, again a significant difference. Overall, after six weeks the MADRS score in Botox-treated patients was reduced by on average 47% compared to 21% for those on placebo.

Author on the study, Dr Norman E. Rosenthal, MD, Clinical Professor of Psychiatry at Georgetown Medical School, commented, “This research is ground-breaking because it offers those who suffer from depression and their doctors an entirely new approach to treating the condition - one that doesn’t conflict with any other treatments.”

Co-author on the study, Dr. Eric Finzi, who first showed a link between inhibition of frowning by facial injection of Botox and reduction of depressive symptoms in a pilot study in 2006, explained: “This new research supports earlier facial feedback theory of Charles Darwin and William James which suggests that facial expressions influence mood.”


Finzi, E. and Rosenthal, N.E. (2014). Treatment of depression with onabotulinumtoxinA: A randomized, double-blind, placebo controlled trial. Journal of Psychiatric Research, Volume 52, Complete, Pages 1-6, May 2014. doi:10.1016/j.jpsychires.2013.11.006

Press release: Elsevier; available at [Accessed 3 April 2014].
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