Don't meet the criteria for Botox for Migraines?

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  • Full Question:

    I have had chronic daily migraines since November 2008. I have tried acupuncture, chiropractic treatments, massage therapy and dozens of abortives and preventative medications. My neurologist suggested botox and referred me to another physician in his practice. The new physician said I do not meet the criteria for botox. I did not receive a satisfactory reason why - first they told me it was because I was on pain medications (which I am not) and then was told I did not qualify because of the number of my migraines. Isn't daily headaches a criteria for botox injections? My current neurologist said he has nothing else to offer me. What do I do now? Rhonda.

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    Full Answer:

    Dear Rhonda;


    The FDA approved Botox for the treatment of chronic Migraine with chronic defined as having a Migraine 15 or more days per month. That said, it can be used "off-label" for patients with Migraines fewer days per month at the discretion of the doctor.


    Your neurologist being out of ideas means it's time for you to find a new doctor. Given your situation, a Migraine specialist would be best. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.


    Good luck,
    John Claude Krusz and Teri Robert



    To review other questions from our Ask the Clinician Column,
     browse the Ask the Clinician archives.


    If you need help finding a  Migraine and headache specialist,
     visit our listing of Patient Recommended Specialists.



    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    Last updated August 1, 2011.

Published On: August 01, 2011