NEWS AND VIEWS
Year : 2011 | Volume
: 2 | Issue : 3 | Page : 216-
FDA approves Botox to treat chronic migraines
Section Editor, JPP, India
Department of Pharmacology, Indira Gandhi Medical College and Research Institute, Kadhirkamam, Puducherry
|How to cite this article:|
Sivagnanam G. FDA approves Botox to treat chronic migraines.J Pharmacol Pharmacother 2011;2:216-216
|How to cite this URL:|
Sivagnanam G. FDA approves Botox to treat chronic migraines. J Pharmacol Pharmacother [serial online] 2011 [cited 2020 Apr 9 ];2:216-216
Available from: http://www.jpharmacol.com/text.asp?2011/2/3/216/83301
Botox injection (botulinum toxin type A) was approved by FDA to prevent headaches in adult patients with chronic migraine. It is given approximately every 12 weeks as multiple injections around the head and neck. It is ineffective for the treatment of migraine headaches that occur 14 days or less per month, or for other forms of headache. 
It is not known how exactly Botox works but believed that it may be due to the diminished release of acetylcholine which in turn may lessen muscle spasm.
It was a serendipitous discovery by a dermatologist, Richard Glogau. About 75% of patients in his case study experienced 4 to 6 months of migraine relief following Botox injection to muscles of the face and head.
A dose of Botox for migraine treatment is 155 units.  The cost (A 100 U vial costs ~ $525) works out to about $775 (~34450 Rs) per dose. The diluted Botox is administered as a series of 31 injections across seven specific regions on both sides of the head and neck (forehead, temples, and neck muscles). This treatment is repeated every 12 weeks. 
One wonders if the cost will worsen the wife's problem (migraine is more common among females) and trigger a new onset migraine to the spouse!
A new report in Drug and Therapeutics Bulletin suggests that the evidence for Botox's effectiveness in chronic migraine is limited and unconvincing and also notes that some specialists are unconvinced of the study. 
Readers may also note that there is a condition called "Medication overuse headache" in which pharmacologic headache treatments by themselves cause rather than relieve headache. 
|1||FDA News Release, Oct. 15, 2010. Available from: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm [Last accessed on 2011 May 3].|
|2||Available from: http://migraine.com/migraine-treatment/botox-for-migraine/ [Last accessed on 2011 May 3].|
|3||Botox (onabotulinumtoxinA) for the treatment of migraine headaches prevention: An introduction. Available from: http://migraine.com/migraine-treatment/botox-for-migraine/ [Last accessed on 2011 May 3].|
|4||Botox for chronic migraine. Drug Ther Bull 2011;49:22-4.|
|5||Tepper SJ, Tepper DE. Breaking the cycle of medication overuse headache. Cleve Clin J Med 2010;77:236-42.|