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Botox\u00ae (onabotulinum toxin A) has been approved to treat frequent migraines since July 2010 by the Medicines and Healthcare products Regulatory Agency (MHRA). Botox\u00ae is not yet approved for infrequent migraines, tension headaches, or cluster headaches.<\/p>\n
Concentrated exposure to botulinum toxin can cause botulism, an illness first studied in the early 1800s, though the bacteria that produces the toxin, Clostridium botulinum, was not actually discovered until much later in the century. \u00a0Seven different types of the toxin, classified A-G, have been discovered. \u00a0A weak solution of botulinum toxin type A (Botox\u00ae) was first used clinically as therapy for squint and blepharospasm. \u00a0Since that time it has been shown to be effective in treating muscle spasms, spasticity and hyperhidrosis. \u00a0Other solutions consisting of botulinum toxin type A and type B are available, but they have not been used to treat headaches.<\/p>\n
In the 90s, people who were being treated with botulinum toxin for other conditions started reporting a reduction in frequency and intensity of headaches. \u00a0Clinical trials for headaches were conducted with unfavorable outcomes. \u00a0In most cases, botulinum toxin was no more effective than a placebo for tension headaches, infrequent migraines and other types of headaches. \u00a0Later examination of the results of the studies suggested that some patients with persistent migraines might see a reduction in frequency, duration or intensity of their headaches.<\/p>\n
1,384 chronic migraine sufferers participated in Phase 3 Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) studies. \u00a0Patients were randomised into Botox\u00ae or placebo. \u00a0Prior to the study, participants experienced headaches 20 days a month on average, with 18 headache days being moderate to severe. \u00a0Participants received injections of either Botox\u00ae or a placebo into specific sites on the head and neck once every 12 weeks over a course of 56 weeks. \u00a0After only two of these treatments, the participants who received Botox\u00ae averaged 8 fewer headache days per month. \u00a0By the end of the study, 70% participants who received Botox\u00ae reported less than half as many headache days as before. \u00a0The side effects of Botox\u00ae were minimal with the most common being neck pain, muscle weakness and drooping eyelids. \u00a0These side effects were temporary.<\/p>\n
Scientists haven\u2019t yet figured out the mechanism whereby Botox\u00ae alleviates migraine pain. \u00a0In most conditions, Botox\u00ae works by relaxing muscles. \u00a0In migraine, it\u2019s thought that Botox\u00ae works by blocking certain neurotransmitters that trigger migraines.<\/p>\n
Only chronic migraine sufferers, those with at least 15 headache days per month, with at least half of headache days being migraines, are currently able to receive treatment with Botox\u00ae. \u00a0Botox\u00ae isn\u2019t the only treatment available for chronic migraines, so talk to your doctor about your options.<\/p>\n
While Botox\u00ae is not restricted to special headache clinics, you should be certain that the person administering Botox\u00ae has been properly trained, both in diagnosing and managing chronic migraines, as well as the administration of Botox\u00ae according to the PREEMPT guidelines.<\/p>\n
Expect to give a thorough history of your headaches, including frequency, intensity, duration, triggers, symptoms and any medications or remedies that have been taken.<\/p>\n