BACKGROUND: Botulinum toxin is a medication made from the bacterium Clostridium botulinum, the most toxic known protein. Sold under the brand names Botox, Dysport, Myobloc, Neurobloc and Xeomin, the drug is used to treat muscle spasms. Botox is probably most widely known for its cosmetic purposes, used to soften frown lines.

Despite the economic downturn, Botox injections were up 8 percent last year. According to the American Society of Plastic Surgeons, more than 5 million individuals got Botox injections to smooth their wrinkles in 2008.

In the 1950s, researchers discovered when small amounts of botulinum toxin type A are injected into overactive muscles, muscle activity subsides. The toxic works by blocking the release of acetylcholine from the nerves to the muscle, preventing it from contracting for three to four months. Botox has many medical applications including the following:

Cervical dystonia or spasmodic torticollis: occurs when the neck muscles involuntarily contract, causing abnormal movements and an awkward posture of the head and neck

Blespharospasm: excessive blinking

Hyperhidrosis: excessive sweating

Excessive salivation

Achalasia: failure of the lower oesophageal sphincter to relax

Migraine and other headache disorders

Pediatric incontinence: incontinence from an overactive bladder

Enlarged prostate

RELIEVING DEPRESSION: Dermatologist Eric Finzi, M.D., Ph.D., medical director and president of the Chevy Chase Cosmetic Center in Chevy Chase, Maryland, says Botox may also treat depression. According to him, the facial expression of emotion may play a role in the subjective experience of emotion.

A small open pilot study was conducted to determine whether inhibiting the expression of facial frowning could alleviate the condition. Ten depressed patients were treated with botulinum toxin A by having it injected into their glabellar frown lines, which are the lines between the eyebrows.

The subjects were between ages 37 and 63 and were all female. Nine of the patients had a unipolar (also known as clinical, major and severe) depression, and one patient had a bipolar disorder. The treatment was tolerated well by all patients with no notable side effects. Nine out of 10 patients were no longer depressed two months after treatment. The one patient who was still depressed -- the person with bipolar disorder -- reported an improvement in mood.

ALLEVIATING MIGRAINES: Researchers have found that Botox injected into the muscles of the brow, eyes, forehead, side of the head and back of the head near the neck sometimes offers immediate migraine relief that can last for up to six months. In a study at the University of California, Los Angeles, researchers reported 51 percent of 96 patients experienced complete improvement of their migraine pain.

FDA WARNING: In February 2009, the Food and Drug Administration (FDA) issued a warning against Botox and its competitor Myobloc, saying children given the drug for muscle pain have died. The drug is not approved for use with children, but it is often used to treat severe muscle spasticity in those with cerebral palsy. It has been linked to dangerous botulism symptoms, potentially causing the muscles needed for breathing and swallowing to become paralyzed or weakened.

For More Information, Contact:
Kelly Brockmeier, Media Relations
Shands Jacksonville
Jacksonville, FL
Kelly.brockmeier@jax.ufl.edu