Botox Injections

[mollymadison]

My pain management doc is suggesting Botox injections for migraine pain control. Has anyone out there had any experience with this and does it work? Any input is welcome.

[Shoreline]

Hey Milly, Unless you headaches have a large muscular element, unlike classic migraines, I really don't see how Botox is supposed to help. However if you have neck problems, and muscular problems where occipital blocks and trigger point injections have been helpful, the botox is a longer acting version of a block. It has no effect on vascular conditions which are supposed to be the cause of classic migraines, but I think often that DX is used too broadly to descibe any type of severe headache.

Insurance companies are being a bear about payng for it for this use as they haven't run the clinical trials for the off label uses it could be efective for.

MY wife has a chiari 1 malformation, it causes head pain and headaches, but the headaches aren't migraine. Initially her insurance covered a few injections but due to the cost, it's been a battle for the last year to use Botox. It was very helpful and less invasive than nerve blocks. There is a less expensive version of Botox A called Botox B. If your insurance won't pay for the botox, your doc can write you a prescription for BotoxB and you can bring the botox to the office for him to administer. This method brings the cost of the botox down to about 350 bucks versus $1200-2K for Botox A injections. Botox B is very similar, it was brought on the market to create a less expensive product available to more people. Chemically it's a slightly different so it's not considered a generic, but the results should pretty much be the same as far as paralyzing muscles that are causing tension type headaches, neck pain, whiplash pain or head pain. Because migraines are vascular in nature, It may be a tough sell to your insurance co since botox has no effect on the CV system.

The last denial from my wifes insurance requested clinical data suportng the use of Botox for Chiari 1, Unfortunately they aren't going to test it for every specifc diagnosis unless they see a huge market. Off label use seems to be a more frequently used reason for drug companies denying paying for many new meds.

Good luck, Dave

[Tzu]

Originally Posted by mollymadison

My pain management doc is suggesting Botox injections for migraine pain control. Has anyone out there had any experience with this and does it work? Any input is welcome.

If u have been diagnosed with migraine .. ask ur doc about a tablet that I take called Zomig 2.5mg. I get 6 tablets per script from my doctor and u take one tablet at the start of the migraine and it stops it there and then. As I understand it .. the blood vessles dilate which causes migraine .. this drug makes them do the opposite (constrict) .. For me it has been a god send ... I was taking so much Syndol which has coedine in it .. and it seemed to be affecting my kidneys which was a worry. This is one small tablet (not a pain killer) and within the hour the pain is gone. I also watch my diet as there are various foods I know for a fact trigger my migraines. But if I get a migraine that I have not eaten any trigger foods for ... then I just use this drug

[mollymadison]

Tzu=
I am allergic to all the Triptans such as the drug you mentioned so tht is out. I am trying Foircet now and it seems to be helping for about 3 hours at a time but it's better than nothing.

[theweaver2]

[FONT=Comic Sans MS][COLOR=DarkRed] Hi Molly,

I have used botox injections for about 4 years for migraine prevention. It was a Godsend for me... However, most of my migraines were triggered by pain in my neck. I have a lonnnng history of migraines. Had then since I was in my 20's and I'm 55 now.

I was desperate as NOTHING was helping me. I tried every drug know to mankind as a preventative and I couldn't use the abortives EVERY day... so my doctor (neuro) tried botox injections.

The thing is you have to be patient. It took me 3 series of injections (once every 3 months or 6 months) before I noticed the tiniest difference and then the 4th one was a charm!!! I had read it takes a while for botox to work and I stuck with the expensive injections ($600 each) because my insurance was covering them and it was easy to give it a really good chance to work like that.

So, if you can afford it, allow 3 sessions before giving up on them. If you are used to migraines the injections are quite painless... just little pinpricks of pain in various sites. You and your doctor can determine the sites. At first I had so much pain my jaws seemed to be in a constant "clench" . I had a few injections there and the release was amazing... you'd be surprised at how much pain is in clenching one's jaw.

I wish you the best. Migranes are no fun to say the least. You say you are allergic to triptans... How so? and which ones have you tried. I am using Amerge and its been great for me. My migraines have been triggered a lot my hormones my whole life and Amerge is the triptan considered best for those kind. On a good note, menopause, which I am now officially through also brought me some relief.

Have you gone the anti-depressant route for migraine preventative? It seems insurance companies want to know you have tried everything and anything before they will cover botox injections.

Good luck and let me know how things turn out for you.