Botox Little Help for Migraines

Chronic migraines benefit from Botox

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Botox -- perhaps best known for fighting wrinkles associated with aging -- also is approved as a treatment for chronic migraines, though studies evaluating its effectiveness as a headache reliever have been mixed.

A new review study has found that Botox injections provide little relief for patients suffering from debilitating chronic migraines.

"Talk to a neurologist about treatment options."

Jeffrey L. Jackson, M.D., M.P.H., of the Medical College of Wisconsin, found in his review study that on average the drug prevented about two migraines a month in patients that regularly experience 15 or more monthly.

Most reviews conducted as part of the study found that Botox did not offer a benefit to patients with fewer than 15 monthly migraines or chronic tension headaches.

Investigators reviewed 27 randomized placebo-controlled trials that included 5,313 patients and four randomized comparisons between Botox and other medications for treating migraines or headaches. Headaches were then categorized as episodic migraines, or less than 15 a month; or chronic migraines, more than 15 a month.

Other classifications included chronic or episodic tension headaches, and chronic or episodic daily headaches.

The analysis revealed that among 1,115 patients with chronic daily headaches, those who received Botox experienced two fewer headaches a month. The 1,508 chronic migraine patients also averaged two less headaches each month.

No significant difference was found in reducing episodic migraines or chronic tension headaches.

They also found that as compared to placebo, Botox was associated with a greater occurrence of upper eyelid droopiness, skin tightness, neck pain and stiffness, muscle weakness and tingling sensations.

Botox also was compared to other treatments, including topiramate (Topamax), amitriptyline (Elavil), and depacon (valproate sodium injection), and was not found to be associated with a reduction in headache frequency in comparison. It was associated with a greater headache reduction against methylprednisolone (Medrol) among patients with chronic tension headaches.

Botox reduced headaches by nearly three a month as compared to methylprednisolone, but the finding examined only a single trial.

The study will be published in the April 25 issue of Journal of the American Medical Association.

Reviewed by: 
Review Date: 
April 17, 2012
Last Updated:
April 30, 2012