A growing body of research suggests that Botox injections may help alleviate the symptoms of depression, and the boost lasts a lot longer than some of the cosmetic benefits.

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Botox, the very same neurotoxin that also softens wrinkles, curbs excessive underarm sweating, and alleviates blinding migraine headaches (among other uses), may also relieve the symptoms of depression.

This use is still considered investigational and off-label, but a growing number of studies are suggesting that the wonder neuromodulator may help beat the blues without many of the side effects associated with antidepressants, such as weight gain.

Research in the June 2016 Journal of Psychiatric Research explains how it works—a phenomenon called emotional proprioception. “When you inject the frown lines—the 11s between the eyebrows—with Botox or another neuromodulator such as Xeomin or Dysport, it also blocks the brain’s trigeminal nerve, which is what gives us the ability to frown and also tells the brain that we are sad,” explains New York City plastic surgeon Z. Paul Lorenc, MD. In a sense, Botox plays a trick on the brain by making sure this message doesn’t get delivered.

Calling the research “fascinating,” Dr. Lorenc points out that the improvements in depressive symptoms seen in studies have been “significant.” He has been noticing that winter blues, also known as seasonal depression, tend to subside in people who receive Botox injections at his practice. (Dr. Lorenc was not affiliated with the new study.)

There are other theories on how Botox can improve mood. “You look better, you are perceived better, and you feel better about yourself,” he says. “The cosmetic effect is part of it, but there is much more to it.” Studies show that the antidepressant effects outlast the cosmetic ones.

The study authors, a prominent psychiatrist Norman Rosenthal, MD, Clinical Professor of Psychiatry at Georgetown University Medical School, and Maryland dermatologic surgeon Eric Finzi, MD, PhD, are also optimistic about the role that Botox may play in treating depression. “We suggest that Botulinum toxin type A may be considered a potential Rx for depression,” they write. “As more data accumulate, we will learn when and how best to deploy this new tool.”

At least one psychiatrist, David Straker, DO, a staff psychiatrist at several New York Hospitals including New York Presbyterian-Columbia, isn’t 100 percent sold on Botox as an antidepressant just yet. “Evidence shows that Botox can be helpful, but large studies have not been done,” he says. “Clinical trials are taking place, but it is not yet U.S. Food and Drug Administration-approved.”

He also cautions, “If someone has major depression and Botox is used alone without psychiatric or psychological monitoring, symptoms could worsen,” he says. “Only in mild cases would I recommend Botox alone.” Here’s how to tell if it’s clinical depression or just the winter blues.

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