Hello, Dr. Watson and Teri. I have what I hope is a quick and simple question to answer. How many times is it advisable to try Botox for migraine prevention? I don’t want to sell it short, but even with insurance coverage, it’s an expensive treatment, and some of the injections go beyond uncomfortable to painful. I’m usually not a big baby about needles, but the injections in the eyebrow and forehead area really do hurt. I saw no results from the first treatment, but I’ve heard that Botox should be tried more than once to give it a fair shot (pun intended). Thank your time and expertise, Jenelle.
The migraine preventive effects of Botox tend to be cumulative with patients getting more benefit from each subsequent treatment until it reaches maximum effectiveness. It’s not all that uncommon to get little or no noticeable results from the first Botox treatment, but to have success with the second or even third round. If, after three rounds of Botox, there are still no results, it’s then reasonable to come to the conclusion that Botox isn’t going to work for that patient.
We don’t consider you a “big baby” for saying some of the injections hurt. They can hurt. That’s a simple fact. For a method that may reduce that pain for you, check out Botox for Migraine - A Suggestion for Easing Injection Site Pain.
Thank you for your question,
Dave Watson and Teri Robert
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© David Watson and Teri Robert, 2016.
Dr. David Watson is a UCNS certified migraine and headache specialist and the director of the West Virginia University Headache Center. Dr. Watson takes a special interest in migraines, cluster headaches, and tension-type headaches. He strives to stay up-to-date on current research and treatments and regularly attends continuing medical education conferences. “Dr. Dave” is also very active in the migraine community, taking part in and leading advocacy efforts to benefit the entire community. He is the founder and chairman of the board of Runnin’ for Research, a nonprofit organization that helps interested patients and doctors set up races in their areas to raise research funding for headache disorders. He’s also a regular participant in the Alliance for Headache Disorders Advocacy’s “Headache on the Hill” event and is co-secretary of the American Headache and Migraine Association. You can follow Dr. Watson on Twitter.
Teri Robert is a leading patient educator and advocate in the area of migraine and other headache disorders, and has been writing for the HealthCentral migraine site since 2007. She is a co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association. She received the National Headache Foundation’s Patient Partners Award for “ongoing patient education, support, and advocacy,” in 2004 and a Distinguished Service Award from the American Headache Society in 2013. You can find links to Teri’s work on her web site and blog and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.