2/4/2017 12:00:00 AM
Can Botox effectively treat depression? A recent review article suggests that indeed it can, confirming that facial expressions play a role in influencing depressed moods.
Z. Paul Lorenc, M.D., isn’t surprised. For years, he’s been injecting neuromodulators into patients who suffer from the winter blues. “Because neuromodulators control these facial muscles, injections can combat depression,” Dr. Lorenc tells Cosmetic Surgery Times.
Clinical trial data from the article published in the Journal of Psychiatric Research suggest that botulinum toxin injected into the brow muscles effectively treats depression through the concept of emotional proprioception, “which is tied into our emotions,” says Dr. Lorenc, who is in private practice in New York City. “For example, the emotion of sadness is manifested by frowning in the glabellar lines. Removing these lines with neuromodulators eliminates the proprioception of sadness and the depression is lessened.”
The sense of well-being after neuromodulator injections “has been around for a number of years,” Dr. Lorenc notes. “This is something that we see in our practices over and over again. But the proposed new mechanism I find fascinating. Facial musculature is being used to sense the environment, then relating that to the brain.”
Winter is more likely to cause depression, due to less light exposure and less outdoor activity. “We see an uptick in patient traffic in the winter months,” Dr. Lorenc says.
In Dr. Lorenc’s office, a patient prone to winter blues schedules one office visit every 3 to 4 months. “However, treatment is very dose-dependent as well,” he conveys.
Prior to injection, the patient exaggerates the activity of the muscle, which Dr. Lorenc marks. “I then inject in those appropriate areas, usually a total of five or six injections if I only treat the area of the glabella,” he explains.
A treatment session lasts 15 to 20 minutes. “Usually there is no bruising, only a little bit of swelling that lasts perhaps a few hours,” Dr. Lorenc says. “Patients can resume full activity right away.”
Typically, it takes three days to notice the effect of the injection. “The majority of patients are extremely satisfied with the results,” Dr. Lorenc observes. “Patients have a better sense of well-being and happiness. They feel more positive about their lives and feel more confident.”
Benefits Beyond Depression
People also report feeling and looking younger than their chronological age.
“Patients perceive such an injection as a pick-me-up,” Dr. Lorenc says. “They feel better about themselves. When they look in the mirror, they look well-rested and do not look tired.”
Patients also are no longer perceived as being angry. “I have teachers who I treat that tell me that their students think they are always angry,” Dr. Lorenc says. “But these teachers say they are not really angry, simply that they have prominent glabellar lines.”
Overall, neuromodulators have a positive impact on how patients are perceived by others.
Dr. Lorenc emphasizes, though, that he is not treating patients who are clinically depressed, even though past clinical studies of Botox have shown that patients on antidepressants achieved an overall 61% improvement in depression.
“This a huge improvement compared to placebo, which showed only a 12% improvement,” Dr. Lorenc reports.