Yes, Botox can help reduce migraines. The beneficial effect for migraine was first noted in patients who were treated with Botox for cosmetic purposes. This led to formal studies that demonstrated improvement in patients with chronic migraine over a placebo, and the FDA approved Botox for the preventative treatment of chronic migraine in October of 2010.
Chronic migraine is defined as 15 or more headache days per month,
with each headache lasting four hours or longer.
Following FDA approval, a recommended injection protocol has been in place that details the injection sites and dose of toxin administered. A small amount (five units) of Botox is injected in each of 31 defined muscle sites in the head and neck. Although 31 sites must be injected, the procedure occurs fairly rapidly and the injections are generally well tolerated.
One advantage of using Botox is that there are minimal systemic side effects. Unlike oral pharmacologic treatments, dizziness, sedation and cognitive side effects are unlikely to occur with Botox treatment. There are also few interactions with other drugs. The beneficial effect can last three months or longer. Some disadvantages include discomfort or bruising from the injections, over-weakening of muscles that are injected (although this is uncommon), and cost. However, most side effects are transient, and insurance coverage has been improving over time. Check with your health plan to see if you are covered for this treatment.
Botox can be a very useful treatment for patients who have not had success with other migraine preventative treatments, either due to lack of efficacy or side effects.