Botox For Migraines?

Migraine headaches are currently one of the most common neurological disorders in the developed world, affecting more than 37 million people in the US alone. In a recent poll, adults of all ages considered migraines to be one of the top 20 disabilities that they lost healthy years to. Despite its debilitating and far-reaching effects, it is one of the least publicly-funded conditions of all neurological illnesses relative to its economic impact. As college students, many of us are oh-too-familiar with migraine headaches; debilitating headaches that cause intense pulsing or throbbing pain are often called “sick headaches” because they are accompanied by nausea and sensitivity to light and sound.

To all the migraine sufferers out there— there is good news. The FDA believes that Botox injections may be effective in the prevention of migraines. A recent article published in Headache magazine further substantiates this claim. In the scientific study related to the article, Avi Ashkenazi explores the use and effectiveness of Botulinum toxin to treat migraines, and in the process, gives a new face to Botox, the conventionally used cosmetic filler that has accrued household-name status over the years due to its explosive popularity in dermatological clinics.

Botox, which is produced by the bacteria Closteridium Botulinum, is one of the most potent toxins found in nature. Until recently, the toxin’s biggest contribution to society was its reversible, dose-dependent muscle-relaxing properties, making it the ideal wrinkle-preventer. Aside from its muscle-relaxing properties, however, Ashkenazi’s team found that Botox produces pain-relieving effects as well.

While studying Botox for treating headaches, mixed results pushed the researchers to break the generic category of headache into more specific brackets. Two large, randomized controlled trials studying episodic migraines (EM) and tension headaches failed to show a significant beneficial effect of BoNT. However, when two large trials were performed on those with chronic migraines or chronic daily headaches, BoNT was a success. Two trials were conducted during which patients were either injected with Botox or given a placebo. In both trials, patients who had received the Botox treatment experienced far less pain and noted a significant improvement in their quality of life.

In cases that showed a positive correlation between BoNT administration and pain-relief, a headache index, which is a composite measurement of headache frequency, severity, and duration, showed that week eight post-injection was the time period during which patients had a minimal headache frequency and felt the least pain. These effects lasted for about three months.

At this point, Botox to treat migraines has only been approved for people with chronic migraines, which has been defined as a “distinct and severe neurological disorder characterized by patients who have a history of migraine and suffer from headaches on 15 or more days per month with headaches lasting four hours a day or longer.” In addition, side effects have been noted which include neck pain and headache. Other side effects are related to symptoms related to the effects of the botulinum toxin spreading from the area of injection to other areas of the body, and include swallowing and breathing problems.

At the same time, the toxin’s overall safety has been studied and proven by decades-worth of clinical use.  The FDA says it knows of no confirmed cases of the spread of the toxin effect when Botox has been used at the recommended dose to treat chronic migraines. Botox for headaches, and not just for wrinkles, appears to be a clinical breakthrough, providing a new twist on an old classic. In the near future, Botox can help alleviate some of that migraine pain, and provide relief for those afflicted with this neurological disorder.