FDA approves Botox as treatment for chronic migraines

New York, N.Y. Posted: 2:58 PM Aug 1, 2011 Reporter: Maureen McFadden

After more than a decade of off-label use, the Food and Drug Administration (FDA) has finally approved Botox as a treatment for chronic migraines.

After more than a decade of off-label use, the Food and Drug Administration (FDA) has finally approved Botox as a treatment for chronic migraines.

Although some use the word very loosely, migraines are far more severe than a typical headache and cost the United States $20 billion each year in lost wages, disability payments and health care bills.

Migraine pain can be so severe, for some, it can become a driving hazard. For Irene Devine, driving, rain and lights were all it took to trigger her migraines.

"I would be vomiting," said Devine. "I would be really debilitated."

For others like Sharon Roth, the persistent pain never seemed to end, lasting nearly 20 hours each day. Her migraines could be triggered by anything, even scents and stress.

"It feels like somebody has taken a dagger and a knife and just stuck it in the side of my head," said Roth. "My migraine controlled me. I couldn't control my migraine."

Many patients suffering from chronic migraines have tried countless medications and even acupuncture. Some turned to Botox, a purified toxin and muscle relaxer.

"There are certain messengers that are expressed in migraine headaches. Botox botulism actually inhibits those messengers blocks those messengers," said doctor Robert Duarte, director of Long Island Jewish Hospital's Pain and Headache Treatment Center. "Generally you are putting about 30 to 31 injections, needles into their forehead, temple and back of the neck."

Relief can start in about six days and last up to three months. Duarte warns that minor neck pain is a side effect.

For many chronic migraine sufferers, doctors believe it may actually be a safer option as many often over-use pain medication.

Since their Botox injections, both Devine and Roth still have some multi-migraine days. However, both can tell there is a difference.

"We were selling fragrances and I did it," said Roth. "I was able to stand one of the triggers."

"I feel very confident that I can get myself around and that's a very good feeling," said Devine.

To qualify for the Botox migraine treatment, patients must have had migraines more than 15 days per month and for more than four hours per day.

Patients must also have had those symptoms for more than three months and have tried other medications.

The entire treatment can cost between $800 and $1,600 but since the FDA approval, the injections have become easier for patients to pay for as the treatment is covered by insurance.

Research Summary:
Botox For Migraines: Erasing Migraines, Not Miracles
Background: Migraines are more severe than a typical headache and are often accompanied by symptoms such as nausea, vomiting, or sensitivity to light. Migraines may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals, including serotonin, which helps regulate pain in your nervous system, also may be involved. In the U.S., more than 30 million people suffer from a migraine, which means there is a migraine sufferer in 25% of all U.S. households. (Source: Mayo Clinic, migraine.com)


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