t

Dr Patrick Treacy

Ailesbury Clinic Dublin

RSM London Feb 2013

t

Botox can cure Depression

t

t

However, this report must be considered anecdotal as there were no appropriate methods of control utilized. In addition, there were other methodological weaknesses including limited follow-up, lack of randomization, the absence of blind evaluation, and especially the small number of individuals included.The method evaluating depression should be more rigorous. Patients’ self-report of depressive symptoms by administration of the BDI-II introduces a significant self-report bias. This is of more concern because of the potential for secondary gain. While the BDI-II is an accepted method of evaluating an individual’s level of symptoms over time, self-report in isolation is not an acceptable method of diagnosing depression. In order to ensure that patients’ psychiatric symptoms are accurately classified, a thorough psychiatric interview must be conducted, and a second blind evaluator would add some credibility.That being said, this is an intriguing report, which fits with our clinical impression. Obviously further work is merited on this important observation.ALASTAIR CARRUTHERS, FRCPCVancouver, Canada

t

I must say that I was initially heartened to see the study of the treatment of depression with Botox as many doctors will reveal a similar picture from their patient's own experience. I examined Finzi's paper in the Journal of Dermatologic Surgery and have concerns that this doctor used a very small number of patients, lacked a control group, had no psychiatrist assessing the patients and even allowed the patients to assess themselves. I noted in an accompanying commentary, that editor Alastair Carruthers, also cited a series of flaws with the study and concluded that its finding must be considered anecdotal. It is of more than passing interest that this doctor has now filed a patent concerning this treatment. If Botox does relieve depression then this is not the paper to prove it. .Dr. Patrick Treacy Dublin Ireland .

t

t

t

t

In the first randomized, controlled study on the effect of botulinum toxin—known commercially as Botox—on depression, researchers investigated whether it might aid patients with major depressive disorder who had not responded to antidepressant medications. Participants in the treatment group were given a single dose (consisting of five injections) of botulinum toxin in the area of the face between and just above the eyebrows, whereas the control group was given placebo injections. Depressive symptoms in the treatment group decreased 47 percent after six weeks, an improvement that remained through the 16-week study period. The placebo group had a 9 percent reduction in symptoms. The findings appeared in May in the Journal of Psychiatric Research.

t

In a functional neuroimaging study, Andreas Hennenlotter and colleagues asked participants to perform a facial expression imitation task in an fMRI scanner before and two weeks after receiving botox injections in the corrugator supercilii muscle used in frowning. During imitation of angry facial expressions, botox decreased activation of brain regions implicated in emotional processing and emotional experience (namely, the amygdala and the brainstem), relative to activations before botox injection. These findings show that facial feedback modulates neural processing of emotional content, and that botox changes how the human brain responds to emotional situations. Hennenlotter et al., 2008

Functional MRI and glabellar botulinum injection

These findings show that facial feedback modulates neural processing of emotional content, and that botox changes how the human brain responds to emotional situations. Hennenlotter et al., 2008

t

The facial feedback hypothesis states that facial movement can influence emotional experience. For example, an individual who is forced to smile during a social event will actually come to find the event more of an enjoyable experience. The free expression by outward signs of an emotion intensifies it. On the other hand, the repression, as far as this is possible, of all outward signs softens our emotions... Even the simulation of an emotion tends to arouse it in our minds.

t

The facial feedback hypothesis states that facial movement can influence emotional experience. For example, an individual who is forced to smile during a social event will actually come to find the event more of an enjoyable experience. The free expression by outward signs of an emotion intensifies it. On the other hand, the repression, as far as this is possible, of all outward signs softens our emotions... Even the simulation of an emotion tends to arouse it in our minds. Charles Darwin 1872

t

The facial feedback hypothesis states that facial movement can influence emotional experience. For example, an individual who is forced to smile during a social event will actually come to find the event more of an enjoyable experience. The free expression by outward signs of an emotion intensifies it. On the other hand, the repression, as far as this is possible, of all outward signs softens our emotions... Even the simulation of an emotion tends to arouse it in our minds.

t

Charles Darwin was among the first to suggest that physiological changes caused by an emotion had a direct impact on, rather than being just the consequence of that emotion.

Charles Darwin concluded work on The Descent of Man on 15 January 1871. On 17 January 1871, he started work on The Expression of the Emotions, employing the unused material on emotional expression. He published on 22 August 1872.

t

t

Jean Carruthers invented Botox for wrinkles?

t

t

t

tThe cosmetic effect of BTX-A on wrinkles was originally documented by a plastic surgeon from Sacramento, California, Dr. Richard Clark, and published in the journal Plastic and Reconstructive Surgery in 1989.

t

t

Dysport diffuses more than Botox?

t

t

Bushara invented Botox for sweating?

t

tSweatingWhile treating patients with hemifacial spasm at Southend Hospital in England in 1993, Khalaf Bushara and David Park were the first to show botulinum toxin injections inhibit sweating.[10] This was the first demonstration of nonmuscular use of BTX-A. Bushara further showed the efficacy of botulinum toxin in treating hyperhidrosis (excessive sweating). BTX-A was later approved for the treatment of excessive underarm sweating. This is technically known as severe primary axillary hyperhidrosis - excessive underarm sweating with an unknown cause which cannot be managed by topical agents.

t

t

t

t

t

t

t

t

Can you be allergic to Botox or Dysport?

t

t

Can Botox travel into the brain?

t

t

Cosmetic Botox is a dangerous drug?

t

t

t

t

One Botox case cost Allergan $0.3billion?

t

t

Should you lie down after Botox?

t

t

Botox was always insurable?

t

t

Botox could make stroke victims walk again?

t

t

Botox can prevent migraine headaches?

Gracias!