Botox For Migraines?

Yes!

An article in the financial section of my newspaper this morning noted that Allergan's stock was up over 11%. The financial market had reacted to news that Allergan had had a positive trial in the use of botox for migraine.

In the trial, the average patient suffered from chronic migraine 15 days per month and experienced both a reduction in number of days per month and in severity of pain per episode with the use of botox injections. As a result, Allergan will be pursuing further testing in order to get FDA approval for the drug as a migraine preventative.

There really aren't very many approved treatments for migraine. There are a lot of drugs used off-label, but surprisingly few drugs approved for migraine prevention or treatment. I know, because I've taken most of them.

I've used botox for years now, and it DOES work. According to my Beverly Hills dermatologist, it actually only works in about 30% of patients on whom he tries it, but for those patients, it is a real godsend. And yes, he believes it is safe: so much so that he injects his son.

I found out about it because I complained about my ever-increasing headaches to my wonderful rheumatologist. I have the best rheumie anyone could want. Around our house, he's referred to as the "divus" (Latin for "divine") doctor. And he referred me to my dermatologist. I drive somewhere around 2.5 hours to see them both. It's worth it.

My derma got into using botox in his practice precisely because it did work on his son. A friend of his, another doctor, had lobbied Medicare to pay for it (successfully) on the grounds that it was cheaper to prevent migraines than to pay for emergency room visits for patients who had frequent, ongoing headaches. When my doctor found what it did for his son, he decided to offer it to his patients. I'm grateful he did.

Botox works for somewhere between 3-6 months on migraines. On me, it's more like 3 months. I know because I keep a headache diary for my neurologist, stating the level of pain I have on a scale of 0-3 morning, noon, and night every day, what medication I use for that pain, and what level of relief I get from it. At the end of the month, I give that month an overall score for pain level. I also note any headache triggers, my cycle, when I get my botox shots, and what preventative drugs I've taken and in what dosages. And I have YEARS of these diaries now.

I can tell that I have the fewest days of migraine pain in the month directly after a set of shots, and the most before a new set of them. My overall pain levels are greatest when my shots are old. Two or three times in the past few years I have missed an appointment with my dermatologist and gone six months between rounds of shots, and that has operated as a sort of control: my number of days with pain definitely increased in months 4-6 and so did my pain intensity.

The logs make it clear that it's worth it to me to go in for the injections. And yes, Medicare pays for it. Medicare gets good value for its dollar, as well, considering that I can also track my E.R. usage when I've had the injections and when I haven't. With injections, I use the E.R. on an average of only three times a year; without them, more than double that. Botox shots cost $300/set of 16 in Beverly Hills. An average E.R. visit for me, including I.V. cocktail of seven drugs, is around $1,300. If the botox saved Medicare ONE E.R. visit, much less 3-4, it would have paid for itself.

For those of you who may be taken in by the advertising for competing products which make a very big deal of "no painful injections" I will say this: I have fibromyalgia and I don't like needles. I also don't particularly like looking like I just walked through a mosquito-infested swamp, which I do for a few hours after my injections. But these shots are NOT painful. I wouldn't get them for fun. Some of them go directly into fibro points. They are uncomfortable. They are not painful. My derma uses a very fine insulin syringe and doesn't take long about it; my entire visit takes about 10 minutes. As soon as the needle is out, the discomfort is over.

I would very strongly recommend checking out a potential dermatologist and making sure that s/he has experience before getting injections. And YMMV. It doesn't work for everybody. Can I swear to you that there can never be any side-effects? Obviously not. But so do the narcs I'd take without the botox to prevent the headaches. So I'll be back in my derma's office on November 10 for more injections.

Have a nice, migraine-free day. And think about buying Allergan. It will be going up when FDA trials are over. :)