In October 2010, the FDA gave approval to use Botox for the preventative treatment of chronic migraine headaches. Allergen, the manufacturer of Botox, has long sought approval of Botox for migraine treatment. After conducting numerous nationwide clinical studies using Botox for headache, the most recent study, PREEMPT, showed that patients suffering from chronic migraines who were treated with Botox for preventative therapy, had significantly fewer headaches days a month than those that did not get Botox.

Chronic migraine, as defined by having more than 15 headache days a month, is one of the most disabling conditions a person can suffer from. A severe migraine can be more disabling than blindness, rheumatoid arthritis or even chest pain (angina). It is estimated that there are 3.2 millions Americans who suffer from chronic migraine. This condition affects quite commonly working aged individuals. Seventy-five percent of affected migraine sufferers are female. Migraine and headaches are a complex medical disorder which can be affected by stress, poor sleep and dietary habits. These individuals tend to overuse over-the-counter medications resulting in rebound headaches. Preventative therapy and not constantly taking abortive medication is the correct approach to managing most headache and migraine disorders. The objective is to prevent the headaches from occurring in the first place. With optimized treatment, it is usually possible to get most patients down to a manageable number of headaches per month – in our clinic four headache days or less. Only then would abortive medications be used. Narcotic medications of any kind should almost never be used for the treatment and management of migraines or headaches.

Botox is not the answer to everyone’s headache and migraine problem. This is only one of the many treatment options that headache specialists have to manage chronic migraine and other headache disorders. Careful patient selection and meticulous Botox administration are necessary to have improved outcomes in headache reduction. Not all individuals will respond to Botox, just as any other preventative medication. Botox should not be considered the first or even second line treatment for patients suffering from chronic migraine. It should be reserved for those that meet the criteria for chronic migraine and have adequate trials of most other preventative medications. Botox administration also requires a patient to receive the drug administered via a number of injections in the scalp and upper neck regions. The smallest needles are used to minimize any discomfort. If successful, a patient who responds to Botox may get as much as two to three months of relief. Getting perceived relief for only 2-3 weeks is not considered a successful response to Botox.

If you think that you suffer from chronic migraine headaches, you should call us today for a complete evaluation and then have a treatment plan designed to address your specific type of headaches.


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