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When I saw the local neurologist a few weeks ago, he strongly suggested I consider receiving Botox injections. I've been thinking hard about whether this is something I want to pursue ever since the appointment.
The injections will be expensive (approximately $1,000 every three months), and my insurance will not cover any portion of the cost.
I'm getting some relief using the Ketamine nasal spray, supplements and herbs and Namenda.
There have been serious questions raised about the safety of Botox injections for purposes other than cosmetic. Cosmetic uses of Botox are generally considered safe because so little of the medication is used in these procedures. But when used for medical applications much more of the medication is injected into the patient, which has led to a variety of complications, including respiratory failure.
The latest study indicating that Botox is effective in preventing migraines was limited to patients who, like me, have not responded to oral preventative therapies. The fact that the group receiving the Botox had greater relief than the group receiving placebo bodes well for the chances it might help me.
Further, the doctor who would be giving me the treatment learned the protocol he uses from the authors of that study, so I know I'd be receiving the same treatment as was part of that study.
However, patients did not obtain the benefit from Botox until six months after receiving the first set of injections. This means I would likely have to commit to receiving at least three sets of injections (every three months) to fully be able to rule out the Botox as a viable option. Doing it just once would not seem to be sufficiently revealing. That's a minimum investment of $3,000 and potentially absolutely no benefit.
And there are other studies calling the efficacy of Botox for migraine prevention into question. Guidelines developed by the American Academy of Neurology and released in May 2008 concluded Botox was no more effective than placebo in preventing migraine attacks and should not be offered to patients with episodic migraine or chronic tension type headaches.
I'm quite honestly completely at a loss at how to reconcile these completely opposite conclusions. I'm disinclined to go for it any time soon. My instincts are telling me no, and I don't feel there is probably much chance it will help.
Sources:
A Few Words of Caution for Botox Users
Botox Shots May Help Ward Off Migraines
Botulinum Toxin Type A as Migraine Preventative Treatment in Patients Previously Failing Oral Prophylactic Treatment
Botox Works on Muscle Disorders But Not Migraines
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Content by Diana E. Lee.
12 comments:
ugh, i so hate things like this. especially when they're really expensive, i can't tell if i should go with my gut or if my gut is just my cheap side. :/ know what i mean? good luck figuring it out!
I haven't tried it myself but American Academy of Neurology's recommendation seems a bit more credible. Most of the studies and articles supporting Botox for migraine treatment that started to appear after AAN made the announcement sound more like PR releases than research.
Botulinum Toxin (botox) is the most toxic natural protein on this planet. It is a poison that interferes with nerve impulses. If ingested, the resultant botulism could result in paralysis or death. The effect of injecting Botox (registered trademark held by Allergan Inc.) into the scalp is to deaden the nerve endings so that headache pain cannot be felt. Shots may also go into neck or shoulder muscles to relax tension that contributes to headache.
Getting botox shots is only a temporary solution and only masks what is really going on. While it may provide much needed pain relief to someone with consistent headaches, others get the shots and still feel pain. If you choose botox, the real issues are not being addressed so the headaches will keep coming back.
Diana, I can honestly say that Botox is one of the few things that's given me any relief. I had my doubts about it, but when I found out my doc has been doing Botox for his migraine patients for a while now, and *none* of them have had a bad reaction, I felt much better about it. And I'm glad I did it! It hasn't broken my continual pain, but it has significantly decreased my pain, and also gotten rid of some of my migraine symptoms (including allodynia).
If you do decide to try Botox, make sure you go to a doctor experienced in giving it to migraine patients. Ask about his track record and his results with his patients. My doc told me he sees about a 75% success rate in his clinic with Botox, including some with complete relief.
I can understand your reluctance to try it. If you have any questions, feel free to ask me and I'll share my experience.
Hope this helps!
Be well,
MJ
I've been contemplating the same thing. One thing I've been worried about is what if you don't like the way the shots make you feel, and then your stuck with that sensation or lack of sensation for months??
Oddly, I recently read an article saying that Botox was no more helpful for migraines than the placebo. I had thought about taking part in the study a year of so ago (I forget when it was) but decided against it due to the same concerns mentioned by Glenn. Botox is poison. There has to be a better way.
For those who have found relief, I am so happy you have found a way to deal with the pain and I hope you continue to have great results.
I am 25 years old, I have been getting horrible headaches since I was 3. the doctors told my parents to keep me away from orange juice and chocolate that I did it for attention. She told them I eat neither. When I got to 13, I started to lose my vision with the headaches. I've seen neurologist after neurologist, done test after test. I'm told that I get 3 different types of Migraines. Weather - when the barometric pressure changes, then I get the ones where I lose my vision, then the lastest I was starting to get Ocular migraines where the headache never came, my eyes would just swell and I would get vision blurred. I can go straight weeks where I can barely lift my head as you all probably get. I have tried numerous medicines both daily and when I get them. At the moment I am on 200mg of Topamax and 400mg of Zonegran a day (just got of of 20mg of lexapro as well). I am about to come off of the topamax, and in a month get off of the zonegran. I have been on too much medicine for years and want to see if anything changes being off. I have been on shots, nose sprays, oral medications but nothing gives any sort of relief. My doctor wants to see if botox will do anything. My insurance denied me 4 times because "headaches are not bad enough" so I will pay out of pocket, but want to see what others feel about, because I do not know anyone that has gotten this before. If anyone could give me any sort of guidance I would really appreciate it. Thank you. - Danielle danigillespie@gmail.com
Botox gave me my life back--that simple. I am trying to find a doctor who is closer to me since I don't particularly like my current doctor (the one who started the program retired and this one is new) but for me it has been a Godsend.
I had the migraine protocol (100 units) a year ago. I had horrible side-effects with no relief to my migraines. I really didn't hesitate when approached with receiving Botox since I have been suffering since childhood and I had been receiving Botox for cosmetic reasons for 4 years prior (without incident).
I want to add this for those who currently use botox (small cosmetic doses) and then receive a larger amount and have adverse reactions - Don't use Botox again! It has been one year since my protocol. Thinking that my side-effects were the cause of so much Botox. Two weeks ago I saw my trusted dermatolgist who injected cosmetic Botox. I can't believe I am having the same issues and worse. They are scary: Blurred vision and burning eyes, upper eyelid Ptosis,extreme headache, throbbing head and neck.
The worst is that there is no cure for this and one is left mentally stuggling wondering when it might wear off.
I found your site while researching migraine treatment w/Botox and wanted to toss in my 2 cent (in case anyone else is looking for this info). My doctor suggested this as a course of treatment because I get what are basically muscle cramps in my scalp that cause or trigger my migraines. My insurance did approve it, however some of her other patients who have tried it did not get insurance help, BUT she was able to contact Allergan (the manufacturer) and they provided several free vials per patient and also heavily discounted rates. Since it's for medical necessity, rather than cosmetic, the company took some deep discounts. The vial itself (according to my doc) lasts for multiple treatments and the cost at which Allergan was providing it made it so that each treatment came out to something like $80. Which is still a bit spendy for some people, but if it can give you 6 months of help/relief, it's worth it. I start getting my injections next week, and will be posting on my blog about the experience, if anyone is interested.
I just wanted to let you know about the discounts available -- doctors have to contact the company and show medical proof & stuff, I'm sure, but maybe nudging the doctor might help someone who can't pay get the help they need.
Wow, giddy girlie! $80 is a lot better than $1,000+, which is what I paid each time I tried Botox for my migraines. That's awesome that your doctor took the initiative to get the manufacturer to help out her patients. I hope your comment will help other people in similar situations. Thanks so much for leaving it.
I hope the treatment will be a help to you!
Diana
I'll be sure to check back once I get the injections (scheduling for next week). My doctor even offered to give me cosmetic injections if I wanted (which I don't) because they give you the vial to take with you (she can't store it). *fingers crossed*
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