That’s how it smooths wrinkles: when you immobilize the muscles that surround fine lines, those lines are less likely to move–making them less noticeable. But when injected in tiny doses into targeted areas, it can block signals between nerves and muscles, causing the muscles to relax. Ingested in contaminated food, it can interfere with key muscles in the body, causing paralysis and even death. The range of conditions for which doctors are now using Botox is dizzying, reflecting the drug’s unique characteristics as much as the drug industry’s unique strategies for creating a blockbuster.īotox is a neurotoxin derived from the bacterium Clostridium botulinum. The depression suffered by Rosenthal’s patient is just one example on a list that includes everything from excessive sweating and neck spasms to leaky bladders, premature ejaculation, migraines, cold hands and even the dangerous cardiac condition of atrial fibrillation after heart surgery, among others. Now, thanks in large part to off-label use, Botox–the wrinkle smoother that exploded as a cultural phenomenon and medical triumph–is increasingly being drafted for problems that go far beyond the cosmetic. For complete access, we encourage you to become a subscriber. That’s because once a drug has been approved by the FDA for a condition, licensed physicians are legally allowed to prescribe it for any medical issue they think it could benefit, regardless of whether it’s been proved to work for that condition.įor a limited time, TIME is giving all readers special access to subscriber-only stories. Such off-label use of Botox, like that of any FDA-approved drug, is legal in the U.S. Food and Drug Administration (FDA) for depression, not that that stops doctors from prescribing it that way. “I’ve found Botox to be helpful, but it’s still not mainstream.” “I’m always on the lookout for things that are unusual and interesting for depression,” says Rosenthal, who is widely considered an expert on the condition. Eric Finzi, an assistant professor of psychiatry at George Washington School of Medicine, published a study showing that when people with major depression got Botox, they reported fewer symptoms six weeks later than people who had been given placebo injections.
In 2014, Rosenthal, a clinical professor of psychiatry at Georgetown University School of Medicine, and Dr. It was peculiar advice coming from a shrink, but not without precedent.