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Botox Appears to Ease Depression Symptoms

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By Shankar Vedantam
Washington Post Staff Writer
Sunday, May 21, 2006

Kathleen Delano had suffered from depression for years. Having tried psychotherapy and a number of antidepressant drugs in vain, she resigned herself to a life of suffering.

Then she tried Botox, the drug that became a rage a few years ago for smoothing out facial wrinkles.

In 2004, her physician injected five shots of the toxin into the muscles between Delano's eyebrows so that the Glenn Dale woman could no longer wrinkle her brow. Eight weeks later, according to a unusual study published this month, her depression had lifted.

"I didn't wake up the next morning and say, 'Hallelujah, I am well, I am healed,' " she said in an interview, but she noticed changes. "I found myself able to do the things I hadn't been doing. I feel I broke out of the shackles of depression to be in the mood to go out, to reconnect with people."

The pilot study of 10 patients is the first to provide empirical support for what a number of clinicians say they have noticed anecdotally: People who get their furrowed brows eliminated with Botox (botulinum toxin A) often report an improvement in mood.

Until now, the assumption was that they were just feeling better about their appearance. But the new study by local dermatologist Eric Finzi suggests that something else may be at work. Finzi found that even patients such as Delano, who were not seeking cosmetic improvement, showed a dramatic decrease in depression symptoms.

"Maybe the frown is not just an end result of the depression; maybe you need to frown in order to be depressed," Finzi said in an interview. "I don't think it has anything to do with making you look better. These patients were not coming to me for Botox; they were coming because I was offering a new treatment for depression."

Some patients in Finzi's study were receiving other treatments for depression; Finzi required that there be no change in those treatments for three months before he injected the Botox.

Finzi agreed that the effects of Botox on depression must be investigated in a much larger study before any conclusions about a link can be established, but a growing body of work suggests that changing expressions can influence mood. People asked to smile while watching a cartoon, for instance, report it is funnier than people who are not asked to smile.

Alastair Carruthers, president-elect of the American Society for Dermatologic Surgery, agreed that Finzi's study provides new insight into a phenomenon clinicians have noticed.

"Anyone who has injected much Botox into the frown area has had people come in and say they can't believe how they feel better as a result," said Carruthers, clinical professor in dermatology at the University of British Columbia in Vancouver, in an interview. "We've not really been able to put our fingers on why. . . . We have been doing research based on appearance, but it may be due to some mood-altering effect of Botox that we don't understand."

Finzi's study was published this month in the society's journal, Dermatologic Surgery.


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