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Primarily known as an anti-wrinkle medication, Botox has obtained U.S. Food and Drug Administration approval this year to also be used as a treatment for migraines. It was discovered that Botox helped migraines when some women who had injections for cosmetic reasons reported that their migraines occurred less often.
Botox was then tried, off label, to treat migraine patients that other medications failed to help. Excited at the prospect of a new application for Botox, Allergen (the manufacturer) funded clinical trials so they could gain FDA approval for the additional use of their drug and now they have achieved their goal.
There are over 30 million Americans who suffer from episodic low level migraines. However, it is thought that the six million additional sufferers of chronic high frequency of migraines (greater than 15 a month) are the best candidates. Dr. Freitag, Associate Director of the Diamond Headache Clinic, reported to the Philadelphia Enquirer that perhaps only half of those or less can be actually be helped with Botox. Freitag has treated over 1,000 patients with Botox injections.
Botox is believed to help relieve the migraines by interfering with the pain impulses from the nerves in the skin that are sent to the brain. Botox also acts to relax the muscles that tighten and create tension around the nerves and blood vessels that contribute to migraine pain.
A treatment may consist of Botox injected into seven different areas including the forehead, temples, back of the head, the neck and shoulders. The benefit from Botox injections has been observed to work from two weeks to as long as two to three months before a repeat injection is needed.
Risks of Botox are thought to be few. The most frequent side effect from Botox use is bruising or swelling at the injection site, transient headache that passes in 24 to 48 hours or generalized flu like symptoms according the American Headache Society.
Hopefully people will be permitted to get reimbursement from their insurance companies now that Botox has been FDA approved for the treatment of migraines, Botox costs over $500 a vial, and four vials would be needed a year.