Botox Cures Depression? Questions You Need to Ask of Medical Studies

Can you treat depression with Botox? That’s the conclusion of a study published last week in the journal Dermatologic Surgery. I was initially skeptical when I heard about the study and reading the particulars did not alleviate my skepticism. Not because I think the idea is impossible, but because the study was so poorly done.

Over the course of the last decade or so in writing about depression I’ve read many studies. Some have been carefully done and some have been poorly done. If a study comes out that may have an impact on you or someone you know, it’s important to put on your skeptical thinking cap and ask yourself some questions, not necessarily about whether the study’s assertion is valid or not, since it’s usually not possible to tell with any real certainty when a study first comes out if this is the case, but whether the study was properly done.

Since there are several factors that can affect a study’s accuracy negatively and skew it in one direction or another, controls have been established over time that help the study to avoid these pitfalls. Controls like double blind, control group and random sampling have evolved out of necessity, and without these controls a study’s results are really just anecdotal.

Take as an example the Botox/depression study. There are many flaws in how the study was done, and they’re flaws you’ll see frequently in published studies.

• The group of people studied was very small – only ten people. The smaller the group, the more likely it is that you will have errors in the data and inaccurate conclusions.
• There was no random sampling. In other words, this group did not represent a cross-section of the population.
• There was no control group – every study participant received Botox. None received a placebo.
• There was no information given as to what severity of depression these women were experiencing before the Botox treatment. Was their depression mild to moderate or severe?

Something else to ask yourself while reading a study is who sponsored it. We’re automatically skeptical of studies that pharmaceutical companies perform or sponsor. But sometimes we fail to look more closely at studies done by universities and other medical institutions. It’s not always obvious to us, without doing some careful digging, that a party with a specific interest in the study’s success was the financial backer.

A friend of mine took a course on Statistics while completing her Master’s of Social Work, part of which was studying and finding the flaws in studies. She was appalled to find out that, as she put it, “You can slant almost any numbers the way you want to.”

And this slanting can be inadvertent as well as intentional. The people conducting studies are human. They make outright mistakes due to inexperience or sloppiness and are in all likelihood biased in favor of their hypothesis, even if they are trying not to be.

It’s possible that we will find in the future that Botox can treat depression. This study goes nowhere as far as proving the possibility, though. Worse, it may give false hope to people who have not responded to conventional treatment. Or it may discourage others from seeking conventional treatment. After all, a Botox treatment once every three months is more convenient than taking antidepressants every day or going to therapy once or twice a week.

The Skeptic’s Dictionary: Control Group Study
Wikipedia Double-Blind Entry
Wikipedia Research Entry