has anyone tried Botox injections for migraines?

Hi, Anita;

YES,YES, AND YES!  I highly recommend it, it gives me 8-10 weeks free of migraines, and only a few minor headaches during that time.  My insurance finally authorized payment for one session, this after one year of efforts to "prove at least 3 other alternative meds failed".  You are welcome to read my profile for more details. 

It is expensive, matter of fact I still am paying off a loan for the most recent session (I had one other prior).  You are very fortunate to have such a forward thinking physician!  Good Luck!

Karen  

My insurance company does pay for the injections. At first the botox was a miracle for me! The first time it lasted 8 weeks but then it started lasting less time until we had to start injecting more and it lasted less to the point that they no longer work for me. I am so bummed because in the beginning it really was the relief that I had been waiting so long for. Good luck and I hope they work for you.

Amy 

If they helped at all, it was minimal.  The frequency of my migraines fluctuates over the year, and I didn't have the botox often enough to be sure.  The only obvious difference was a slight brow-droop.  Maybe you'll have a better result. 

I was part of a headache study by a pain neurologist.  I also had trigger point injections of phenol and anesthetic when my insurance refused to pay for the continued botox treatment.  The botox injections lasted about 4 months , decreasing my headaches from 5 per week to 3 per month. I also had a much improved response with my rescue med since I was having fewer headaches. 

The phenol/anesthetic injections only gave me relief for as long as the anesthetic agent lasted, generally 24-48 hours. 

My advice, ask every family member who normally would be getting you a Christmas/birthday/anniversary present in the next year to make a contribution to your botox headache relief fund instead.  And good luck with your insurance company, mine wouldn't budge.

I have been interested in Trying Botox for a couple of years. I am 47, have had migraines since 18. Tried topomax, (became anorexic on it, didn't help headaches) Imitrex, relpax, elavil. Am on 20 mg pamelor, and 25 mg toprol xl. Still had probs. saw on T.V. a local dermatologist who does botox, and he said his patients reported less headaches. So I went to him April 6th, had injections in forehead. Had two better months for headaches. Told my neurologist, who on July 27th gave me injections in forehead, temple area above my ears, and back of my neck. I went most of August, and all of September without a migraine. Stunned, we decided to keep on with the treatment, along with the low dose of meds I am on. This past Oct 9th I had a migraine with start of my period, but it was easily treated with Imitrex.

My next scheduled injection will be the 26th of October. They tell me at the office they've had some real success. Insurance covered the injections but not the botox.

I am encouraged. Thrilled. Wish that more scientific studies would be done so FDA will approve, just like they have other off label drugs.

I encourage you to discuss it with your Dr. In my opinion, there is nothing to lose trying and maybe everything to gain. I am working now, after being out of work and afraid to try to get a job. Even with the stress of learning, no headaches. I was getting several a month before. I don't believe it is psycosymatic, because if it were, we could all talk ourselves out of migraines. They think the botulism toxin may work with serotonin, along with the muscle involvement.

Best of luck to you

I've tried Botox for about a year now, paying a local plastic surgeon out of pocket because my neurologist doesn't do it (and was reluctant to put his name on docs vouching for a therapy he didn't perform, to see if HMO would cover).  It definitely acted as a "booster shot" for me, improving the results of the preventives (first topamax, now zonegran) and giving me longer stretches of pain-free or pain-reduced time than preventives alone. 

When I tried to taper off topamax, they came back with a vengeance.  So now I take my preventives, but get my Botox every 2-1/2 to 3 months.  I pay $350 a whack (a good price around here) and my credit card isn't happy, but I'll rather deal with debt than more migraines.

I'm currently in a Botox study for migraines. I had my most recent set of injection on Sept. 26th.  I had a on-going when I went in and that migraine last for another 5 days.  Since then I have had on average a migraine every other day.  Which is an improvement from every day.  When I get one now it usually starts late morning or early after and will be gone when I wake up the next morning.  

With my last set of injections, the benefits lasted for about 4-5 weeks before the  migraines were back to how they were back the shots.

~Sharon 

I have been using Botox for migraines for about 5 years. I got dramatic benefit from the first treatment. Initially cut my migraines by 50% in frequency, severity, and duration. I get my injections every 10 or 11 weeks. Most people can wait 12 weeks between injection cycles, some longer.

For about 2 years, I worked for a Neurologist who specializes in migraine, doing prior auth for therapeutic Botox for about 600 patients. We were very successful in getting insurance to pay for the treatment. Proper documentation and coding are key. Also, check your pharmacy plan for Botox coverage. Many require prior auth, but some do not. I have acquired Botox for patients with as little as a $16 copay. I get mine for a non-preferred, formulary, brand name copayment of $80 thru my pharmacy plan. Retail cost is about $600/vial. Usually only one vial is needed. Botox comes in 100 unit vials - my treatments to face and neck use about 75 units. But, I have seen patients successfully treated by injecting the face only with less than 50 units.

The pain of the injections  is nominal - nothing compared to a migraine - migraineurs know real pain. A little *****, a little sting, and done. The anticipation is worse than the injections. Try to stop taking any aspirin, Vit E supplements, etc. about a week prior to injection to minimized bleeding (don't stress it though, you won't bleed to death, just bruise).

If you get injections in the neck muscles you need to be aware that initially it may seem the Botox makes the pain worse. As the those muscles weaken from the Botox, the other neck muscles must take over the load of the weight of the heavy head. Just like the muscle soreness you get after starting a new exercise. It takes a week or so for the neck muscles to adjust. This lessens over time/repeated injection cycles, as the "strong" muscles stay stronger-waiting longer between injection cycles increases the chances of this neck pain, as the muscles have time for the weak muscles to strengthen again, and the strong lose some of their strength due to the decreased load. Horehead injections can occasionally trigger a headache as well. Don't worry, this is relatively rare.

It takes a little trial and error regarding dosage and placement to get the formula for each patient just right. This takes time since it is about 12 weeks between treatments. A couple of tips. Most providers like to start very low in dosage and work up. That is how they are taught, and it is sound advice clinincally speaking. However, if a patient does not get any benefit from it, they are not likely to try it several times until they do, because there is such a long period between treatments and the cost may be very high. Also, with the cost so high, insurance is not likely to continue to pay for any treatment if all the documentation  says the patient repeatedly received little or no therapeutic benefit from it. With Botox treatments, it is usually best to start with somewhat higher doses and widespread placement, and titrate down with successive treatments. 

Keep track of the cost of your other medications while using Botox treatments. This is useful in getting insurance to pay or continue to pay. Even if you have to pay out of pocket, Botox can often still be cost effective due to the reduction in need for your other migraine meds, some of which can be quite expensive. And it is prophylactic, so you don't get the headaches in the first place. Many migraineurs would pay extra for that alone.

Good luck!

Oh, how funny. They bleeped me. Word that was bleeped was "stick", only I spelled it with pr at the beginning instead of st.

One thing I forgot.  Be aware Botox treatments may cause weight gain!  Not really, but I lost so many days of eating due to the N/V before I started using Botox I thought I was naturally thin. NOT! Apparently, I am just as likely as any one else to weight gain when I feel like eating every single day of the year. Beware!

I saw someone else who responded that the botox made her headaches worse, and I have to say they did the same for me.  I had the worst 6 months of my life after being injected.  It was like clockwork, they told me the injections would take affect in 3-4 weeks and last approximately 6 months.  well, 3 weeks after the injections, I was in out of control pain that lasted in some form or other for about 7 months, then all of sudden, went back to the normal hellish pain I usually have! 

Like everyone else though, it was a possibility, so I had to try it.  I think I am in the minority of people that this has happened to, I just tell you primarily so if it happens to you, you won't think you are crazy.

Also, since I know you will want to see if they work for you either way, most likely, I had two docs tell me that there is always some of the botox left over from other people's injections.  I guess once they open the bottle they have to charge for the whole thing or something, even if the person doesn't need or can't tolerate all the medicine.  The docs said if I could wait till they called me, then they would use the left over botox on me and see if it worked, that way I wouldn't pay for the meds, just the injections.  Don't quote me word for word on that, I am not sure why or how they had some left over, I was just trying to fill in the blanks with something that sounded reasonable!  Luckily, my insurance paid for the treatment so they were able to use the free leftovers on someone else.

Just some stuff to think about....

Julie

I just happened to see your post, and all I can say is DO IT!! I am a woman who will be 61 next month. I have had chronic daily headaches and migraines my entire adult life, and in the last 6 months they had gotten to the point where I was becoming an invalid. My neurologist also tried different meds, and they either didn't work or I had nasty side effects. I had my first Botox treatment last Tuesday, and it is a miracle!

I am pain free. My migraines were triggered by changes in the barometer, so I had no control over them. Even if I didn't have a migraine, I ALWAYS had a headache. The Botox stopped that. I can't believe it. It's like coming out of a coma-or a nightmare.

There is no way of knowing how much relief you will get, but boy, it's worth the try....good luck!

Judy in New Jersey

Oh Karen, I got so involved in my very long winded response it forgot something. At one time I considered enrolling in a Botox for migraine study in my area. Not sure if that is the kind of study you were talking about. I opted not to do it because I did not want to risk being in the control group and not getting the Botox treatment. Doing the actual injections is not an especially tricky thing. Maybe you could find a doc in your area who would be willing to inject you. You might want to ask the person who did your injections if they would be willing to speak to someone closer to you, and explain the dosage and placement they used on you.

Check out www.botox.com

Click on the red box in the middle, Botox therapeutic for Neurological conditions. Keep in mind, Botox treatment is off label for migraine, so the website will not talk about migraine treatment. In the upper right of the page is a link for healthcare professionals...this will take you to information for your provider regarding how to obtain reimbursement for therapeutic Botox. Good luck.

Hello, and welcome to MyMigraineConnection.com!

Botox can be a very effective treatment for some people with Migraine disease and various other pain disorders.

Thank you for creating a SharePost.  SharePosts are a form of blogging, and there are many things you can do with them. You can share an experience, suggest something that's helped you, use SharePosts as a Migraine and headache journal, and many other things.

We also have a discussion forum that you may want to check out. Especially if you have questions or are looking for information, you may find the interaction on the forum to be quite helpful. Botox would be a great topic on the forum. To get to the forum, just look for the orange box marked "Manage" and click on the Migraine Forums link. Because our forums are maintained by a third party, you'll need to register for the forum. You can use the same information you used to create your community log-in if you like. If you want to go directly to the forum, you can click HERE.

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Welcome again,

Nancy Bonk
MyMigraineConnection.com Expert

PS: If you receive this message from more than one of us, please excuse the overlap. Thanks!

I wanted to thank everyone for your responses!It was actually overwelming to see all the replies.

I have another appointment with neurologist in several weeks. Hopefully after I share all the info with him we can come up with some way to get insurance to cover the Botox injections. If not maybe I'll start selling "body parts" (lol) to pay for it!

Thanks again for those of you who took the time to reply and help me.

Anita

If you fight with your insurance, they often will pay for the botox.

I used it a few years ago.  The first time I tried it I was headache free for 3 weeks-

for the first time in over 25 years.  Its definitely worth a try.  The first time I paid for the shots but my insurance reimbursed me and paid for them after that.

 It never worked as well as the first time- but it did give some relief.